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Maxilla of a child, at the age of about four years, exhib- 
iting the number, form, and position of the deciduous 
teeth, and the rudiments of the permanent ones, with 
their connections. 



THE PRACTICAL 



FAMILY DENTIST: 



f <pfe Cratise tut % CtA 



EXHIBITING 



THE MJEAN8 NECESSARY AND EFFICIENT TO SECURE THEIR HEALTH AND PRES- 
ERVATION. ALSO, THE VARIOUS EBBOBS AND PERNICIOUS PRACTICES 
WHICH PREVAIL IN RELATION TO DENTAL TREATMENT. 



»i$ u Faring d WiMul Mmfpte 

FOR REMEDIAL COMPOUNDS, DESIGNED FOB DISEASES OF THE TEETH AND GUMS, 



By DEWITT C. WARNER, M.D. 

DENTIST. 



NEW YORK: 

FOWLERS AND WELLS, PUBLISHERS, 

Clintos Hall, 131 Nassau Stbeet. 
Bo 8 ,o„, IJ2 WMfci *-»4 1 853. [London, No. MS Strand. 









<* 



«v» 



Entered, according to Act of Congress, in the year 1S53, by 

£*o u Le ^ ycwiTT o, wamteb, r Vttelt$ 

In the Clerk's Office of the District Court of the United States for the Southern 
District of New York. 



N. T. STEREOTYPE ASSOCIATION, 

201 William Street. 



PREFACE. 



In submitting the following pages to the public, the 
author feels that he is assuming an important responsi- 
bility. By thus presuming to prescribe a course of prac- 
tice involving the weal or woe of those useful and beau- 
tifying organs, the Human Teeth, he is aware that he 
renders himself liable to the censure of the dental profes- 
sion, inasmuch as he has taken the liberty to denounce 
some of its views and practices as absurd, and tending 
only to evil. Conscious, however, of the rectitude of his 
intentions, and being fully persuaded that the wants of ; 
the community imperiously demand a degree c*f correct 
practical information in relation to dental treatment, which 
is not afforded from any source heretofore accessible to 
the masses, he has ventured to put forth this little Manual 
of Dentistry, believing that the practice here suggested is 
in strict accordance with the principles which govern the 



IV PREFACE. 

economy of nature, and which, if once generally adopted, 
would establish a new era in the history of dental science. 
He has endeavored to present, in a concise manner, the 
erroneous views and practices generally entertained, espe- 
cially by the dental profession, and to exhibit in some de- 
gree the vast evils which flow from this source ; and to 
impress upon the mind the importance, as well as neces- 
sity, for the exercise of practical common sense in dealing 
with this subject, as with other matters of every-day life. 

WlLKESBAERE, July, 1853. 



CONTENTS. 



Page 

Introductory Remarks 7 

General Anatomy of the Teeth 29 

Chemical Composition 34 

Form, Number, and Arrangement 35 

Dentition 38 

The Gums, or parts contiguous to the Teeth 43 

Causes which affect them injuriously, and their modes of 

operation 46 

Teething, or the First Dentition 47 

Dentition as a predisposing cause of Caries 53 

Chemical Agents— The result of Putrefaction 55 

Tartar 60 

The Tooth-brush as a cause of Disease 67 

The Dentrifice, a cause of Dental Disease 70 

Filing the Teeth injurious 75 

Cleanliness, as a Bpmedy ' 79 

The Tooth-brush a means to obtain it 85 

The Dentifrice, as a Remedy 86 



VI CONTENTS. 

Fag© 

Scaling the Teeth 94 

Plugging or Filling Carious Teeth 102 

Destruction of the Nerve in order to Plug Teeth 110 

The Extraction of Teeth 122 

Cutting the Gum 125 

Materials for Filling Teeth—Gold 129 

Tin 130 

Silver 131 

Metallic Paste 132 

Artificial Teeth 135 

Inserting on Pivots 138 

Inserting Teeth on Plate 147 

Composition of Plates 155 

Silver for Plate 156 

Platina 158 

Gold 160 

Galvanizing 162 

Artificial Teeth : their Composition 165 

Recipes : No. 1— Compound Tooth Paste 168 

No. 2— Tincture of Cochineal 170 

No. 3 170 

No. 4 171 

No. 5 172 

No. 6 — Metallic Cement, or Amalgam * 173 

No. 7 175 






INTRODUCTORY REMARKS. 

In common with other parts of the human or- 
ganization, the Teeth are subject to disease. As 
other constituent members of the body, they are 
exposed to certain noxious causes, which tend to 
their premature destruction. 

Few persons, indeed, in this luxurious age, are 
so fortunate as to attain to .the meridian of life, 
without having experienced more or less of the 
evils which flow from disease of the dental organs ; 
and it has become an interesting question, how far 
these evils may be prevented, or mitigated, by pro- 
phylactic and remedial means. , 

Quite a large class of individuals, in this coun- 
try, styled Doctors of Dental Surgery, assume to 



8 INTRODUCTORY REMARKS. 

apply the principles of medical science, and the 
improvements in art appertaining to this profession, 
in practical demonstration of their utility, and im- 
mense sums of money are annually expended in 
remuneration for their services. 

Almost every considerable town in the United 
States supports its local dentist, while numerous 
itinerants are passing from place to place engaged 
in this pursuit. 

Their number is rapidly increasing, and it would 
seem, from this fact, and the extended service to 
which the community is calling them, that the 
utility of the profession was proportionately rising 
in its favor. But it is not so. A distrust of the 
ability to accomplish what is claimed for this pro- 
fession by its most worthy members, pervades the 
public mind, especiaUy that portion of it which has 
been subjected to certain generally prevailing in- 
fluences. That there is just cause for the appre- 
hension which is manifested, can not be denied. In 
this profession empiricism has been practiced to an 
extent probably unequaled in any other pursuit. 

It is not uncommon to hear opinions expressed, 
and for advice to be given on this subject, in re- 



INTRODUCTORY It E M A R V 9 

lation to the application of some simple common- 
sense principle, which are directly adverse to each 
other, and which, when tested by experience, are 
found to be entirely different in their practical 
results. 

Cases, therefore, are of frequent occurrence, of 
individuals making application to the profession for 
advice, and what in common parlance is termed 
" dental operations ." with little or no expectation 
of receiving any benefit, even though the dentist to 
whom the application is made may promise all that 
is desired. For it is too true, that the fears of the 
patient are too often realized So frequently, in- 
deed, are the predictions of dentists contradicted 
by experience, that the community generally have 
come to look upon nearly all their operations as 
experiments invested with much uncertainty. 

But there are too classes of persons, each enter- 
taining distinct views in regard to this subject. 

Men generally judge of the merits of a thing by 
the benefit it has conferred upon themselves per- 
sonally, or from those received by others ; and 
hence, while some place implicit confidence and 
faith in the preventive and remedial powers of 

1* 



10 INTRODUCTORY REMARKS. 

dental science and art, others are led to repudiate 
nearly the whole system of dental surgery as mere 
pretension, and incapable of conferring any con- 
siderable or lasting benefits. 

It will be found, however, on inquiry, that the 
views of men who, from personal experience, have 
adjudged this matter, depend very much, whether 
favorable or unfavorable, upon the individual who 
has rendered to them the professional service. 

A thorough knowledge of the principles of den- 
tal science, and the mechanical skill to carry them 
out in practice, should be possessed by every one who 
presumes to assume the important responsibilities 
which devolve upon all those who engage in the 
practice of this profession. Integrity of purpose 
is also an essential concomitant of these qualifi- 
cations. If these qualities were attributable to all 
who engage in the practice of the dental profession, 
the public, no doubt, would have far less reason to 
question its utility. But if this were so, there are 
other considerations which rise up and present 
themselves as formidable obstacles in the way. 

In the first place, there is much of practical 
error entertained by a large portion of the dental 



I JT TB OD U T B Y B E M A EXB. 11 

profession ; not so much in relation to mechanical 
manipulations, as that which refers more particu- 
larly to dental physiology, and the recuperative 
operation of remedies. And in the second place, 
the generally prevailing ignorance which impresses 
the public mind in regard to this most interesting 
subject. 

There is no subject — not even excepting that of 
practical medicine, of which dentistry has generally 

d considered as forming a part — the plain 
principles of which have been BO erroneously taught, 
and around which has been so much mystery thrown 
by its profe880rS, as thifl one ; and, I might add 
with perfect truthfulness, none where imposition 
has been practiced to the same extent; and hence 
the general ignorance and evil practices in relation 
to the dental organs, which prevail among the 

Some of these errors have been adopted from a 
misapprehension of the causes which operate to 
induce certain conditions of the teeth, and parts 
contiguous to them, while others have their origin 
in theory, sanctioned by high authority. The 
medical profession have sustained no inconsiderable 



12 IKTEODUGTORY REMARKS. 

part in the establishment of these errors, and which 
has extended very much the evils resulting from 
their practice. 

It is indeed surprising to one who views this subject 
in the light of science, when the absurd practices 
which prevail are presented to him, they are so 
repugnant to all correct scientific principles — and, 
in many cases, to common sense. And his surprise 
is not at all lessened when he considers that they 
emanate from a learned profession. 

In the application of remedies, there is frequently 
a perfect want of a proper understanding of their 
effects. Circumstances involving the particular 
case are entirely overlooked, both by the dentist 
and those who are the subjects of their application ; 
and results of the most pernicious character are 
often experienced from this want of knowledge, 
when, had the course been pursued which science 
indicated, the evils would have been entirely 
avoided. 

As an illustration of what is here stated, the 
use of the common tooth-brush may be cited as a 
familiar example. 

It is said of the celebrated Esop, who has given 



INTRODUCTORY REMARKS. 13 

us so many instructive fables, that his master, on 
going out with some friends on a hunting excursion, 
gave him directions to prepare dinner of the very- 
best his larder afforded. On returning from the 
chase, a dinner was found served up entirely of 
tongue. On another occasion, he was ordered to 
prepare a dinner of the very worst his master's 
larder afforded. And again also, a dinner was 
served entirely of tongue. Esop being called upon 
for an explanation of the singular transaction, said 
that he had obeyed his master's injunction in the 
first instance, inasmuch as the tongue was designed 
for universal application, and when properly con- 
trolled and directed it was capable of conferring 
the greatest amount of good, and therefore was 
the very best thing in the world. On the other 
hand, when not controlled and directed aright, it 
was susceptible of becoming an instrument for the 
accomplishment of the greatest amount of evil, and 
therefore was the very worst thing in the world. 

The tooth-brush is like Esop's tongues, with this 
difference — its application is limited to the dental 
organs. It is certainly capable, when properly 
constructed and timely applied, of effecting a vast 



14: INTRODUCTORY REMARKS. 

amount of good ; but there is no doubt that it has 
accomplished an immense amount of evil. The 
tooth-brush, as it is commonly found in the market, 
is a stiff, harsh instrument, and when used daily, 
if care is not taken to use it lightly, will, in a short 
time, produce an undue excitement in the most 
healthy gums. A very great proportion of those 
which have been, and are used at the present time, 
are constructed of the common hog's bristle, with- 
out any regard to the object to be accomplished by 
them. With most persons in the purchase of a 
tooth-brush, the price, and not the adaptation of 
the instrument to the end which ought to be had in 
view, determines their selection — acting upon the 
suggestion that a tooth-brush is a tooth-brush, 
" whatever may come out on't," as there is generally 
no definite idea entertained in regard to it. It is 
remarkable, however, that dentists frequently pre- 
scribe this same article, harsh as it may be, and 
hence the mischief which the use of this instru- 
ment produces ; and hence also the idea which 
many entertain, that it is worse than useless to 
obtain the services of the dental profession. 

There is, perhaps, no case presented to the 



INTRODUCTORY REMARKS. 15 

dental practitioner, which will be more readily 
recognized than that of individuals of from fourteen 
to twenty years of age, who have had their atten- 
tion directed to the condition of their teeth — may 
be by the pain of a tooth in its incipient stage 
of the decaying process, induced by inflamed and 
irritable gums, and other causes consequent on the 
neglect of proper attention to cleanliness, which 
usually prevails at this time of life — and who make 
application to the profession for the purpose of 
having their dental organs put in proper order. 
Conscious that disease has commenced its destroy- 
ing process, the patient, having no other source 
to which to resort for advice, or to obtain relief, 
applies to the dental profession. The position of 
the dentist, under such circumstances, is certainly 
a responsible one ; for if his directions be strictly 
followed, they will tell in after years, either for the 
weal or woe of his patient. 

And what is the course usually pursued in such 
a case, by the dental practitioner? If, o.n ex- 
amination, he finds any of the teeth sufficiently 
diseased to require the operation of filling, that 
operation is performed without any previous pre- 



16 IX T B Dl'OTORY REMARKS. 

paration, although there is frequently much ten- 
derness from the existing inflammation. There is 
generally more or less of the substance called 
tartar deposited upon the teeth in such cases, and 
that is also removed by the operation called scaling. 
In effecting this, the gums are usually irritated to 
a considerable degree, as this substance insinuates 
itself below the margin of the gum, and adheres 
closely to the teeth, requiring considerable force to 
remove it. This operation performed, the gums 
remain in an irritable, inflamed state. To remedy 
this condition, dentists generally prescribe some 
dentifrice, of which there are a great variety, some 
of which are, in their effects upon the teeth and 
gums, decidedly pernicious. Having gone through 
this routine of practice, the patient is dismissed, 
with directions to procure a tooth-brush with which 
to apply the dentifrice, which application is to be 
made daily. The brush usually obtained is the 
one to which I have alluded, made of the common 
bristle, stiff and harsh, partaking more of the na- 
ture of the rasp than of an instrument fitted to be 
applied to the tender structure of the gums, and 
more especially in their excited condition. 



INTEODUCTOEY I BK8. 17 

But it frequently happens, that the attention of 
the individual has "been arrested by the pain of a 
tooth, which it has been necessary to extr 
The severity of this operation Bometi .ore 

than meets the expectations of individuals, and 
therefore the fear of again I rabjecte 

similar ordeal has, in such c 
perfect obedience to the professional in 
which have been given. The application of the 
detergent brush, and healing dentifrice, are sedu- 
lously attended to, and thus weeks and months 
pass. But by-and-by the individual observe 
although his teeth may have a little more polish on 
their exposed surfaces than formerly, his gums are 
becoming more sensitive, swollen, and liable 
bleed on using the brush. The teeth themselves, 
also, along the margin of the gums, begin to mani- 
fest indications of tenderness to the touch, till, at 
length, may be in less than a year's time, the 
practice of using the brush has become so annoy- 
ing, or absolutely painful, as to induce the aban- 
donment of it altogether. The dental organs are 
now left to the influence of the same ca '.ich 

had induced their diseased condition previous to 



18 INTRODUCTORY EEMAE1S. 

obtaining professional interference, with the addi- 
tional irritation produced by the scaling instrument, 
and kept up with increasing severity by the daily 
application of the rasping tooth-brush, and fre- 
quently pernicious dentifrice. 

Such circumstances never exist for any con- 
siderable length of time, without some manifesta- 
tion of organic destruction. It is soon discovered, 
therefore, that caries, or mortification of certain 
portions of the teeth most exposed to the delete- 
rious causes which tend to destroy them, has 
commenced its operation. Disease, under such 
circumstances, is generally rapid in its progress, 
modified, of course, by the severity of the operating 
causes. 

What now is to be done ? The healing powers 
of dental surgery have proved unavailing, and 
probably the patient inclines to the belief, that 
what has been done has hastened the present con- 
dition, and hence he has no confidence in the dental 
profession. But he needs no assurance that certain 
destruction awaits these organs, unless something 
is done. And yet, there is no other hope, except 
through this profession. As a dernier resort, 



INTRODUCTORY REMARKS. 19 

therefore, after much suffering, perhaps, the family 
dentist is again consulted. 

The case now presents a different aspect from 
what it formerly did. There are, probably, some 
of the teeth for which there is no remedy, and the 
only proper course is their removal. There are 
others which require to be filled, and in order to 
accomplish this must be separated with a file. But 
all of them are in so inflamed and sensitive a con- 
dition, that a process of preparation is necessary — 
except for those which require extraction — to fit 
them for the plugging operation. But preparatory 
means are neglected, as time is necessarily con- 
sumed in the process. Aware of the repugnance 
which most people feel at the extraction of teeth, 
those which should have been removed are left in 
their position, and in many cases with the sug- 
gestion on the part of the dentist that to remove 
them would be doing an injury. The teeth which 
can be made to hold a pli*£ are filled up, although 
this operation, under such circumstances, is some- 
times very painful. The teeth being filled, the 
patient is again dismissed, with the injunction to 
be particular in the use of his tooth-brush. 



20 INTRODUCTORY REMARKS. 

The diseased condition of the teeth, when plugged 
under such circumstances, is not removed, but 
sometimes very much increased by the excitement 
produced by the filing and cutting away of the 
diseased substance. Hence, in a short time, the 
plugs fall out, the progress of decay continues, the 
sensitive nerves become exposed to morbid influ- 
ences, and toothache, that " hell o' diseases, 55 as 
Burns expresses it, generally supervenes ; and 
finally, one by one, necessity compels their removal, 
until the individual is left, as thousands are annu- 
ally left in our country, even in the springtime of 
life, perfectly destitute of those organs which Na- 
ture no doubt intended should be co-extensive with 
the other members of the physical organization. 

The only hope of relief now left, is in the sub- 
stitution of those expensive artificial means which 
hitman invention has devised to mitigate the ills of 
life which accrue to the unfortunate, and which, 
although they may render them much more tolera- 
ble, afford, in most instances, but a poor substitute 
for those naturally useful and beautifying organs. 

The above picture is not overdrawn. Multitudes 
can testify to its truthfulness ; and frequently, 



INTRODUCTORY REMARKS. 21 

although the result is the same, the reality, so far 
as suffering from dental disease is concerned, far 
exceeds the power of description. 

But the question may arise, wherein are the 
errors of this practice, and how could the results 
stated have been avoided ? 

In answering these inquiries, the first important 
particular which presents itself is, the general 
neglect of parents and guardians in their attentions 
to the health of the dental organs of those in- 
trusted to their care, during the period of, and 
immediately subsequent to, the second dentition. 

That there is culpable neglect on the part of 
those who have the control of youth at this period 
of life, in this respect, and which has an essential- 
bearing upon their future welfare, I shall, in sub- 
sequent pages, endeavor to demonstrate. 

The second error, and one which it would seem 
a little reflection would render apparent to all, is 
the recommendation and use of a stiff, harsh, irri- 
tating tooth-brush. It is indeed surprising, that 
an instrument so illy calculated to accomplish the 
objects for which this one is designed, should re- 
ceive the sanction of a learned profession, or con- 



22 INTRODUCTORY REMARKS. 

tinue to be so extensively used by an intelligent 
community. Should a physician be called upon to 
prescribe for a diseased eye, which disease had been 
induced by irritating substances, who, to remedy 
which, should order the daily application of a 
quantity of sandy particles to its delicate and 
sensitive surface, he would be considered as insane, 
and entirely unfit to be intrusted with the responsi- 
bilities of his profession ; and the patient who 
would obey such a prescription, would be deemed 
incompetent to take charge of remedies which were 
to administer to his own necessities. Disease of 
the gums, in most instances, is induced by external 
causes, acting upon their exposed surfaces, by 
chemical or mechanical process. A harsh, irri- 
tating brush is prescribed as a remedy, and the in- 
junction is implicitly obeyed. And yet the principle 
of action, and the effect produced, so far as expe- 
rience can determine, are precisely the same in the 
one case as in the other ; differing only in degree, 
varying according to the structure and excitability 
of the organ affected. The glaring light of a 
noonday sun, impinging upon the eye, is t not more 
certain to excite inflammation in that organ, when 



INTRODUCTORY REMARKS. 23 

long continued, than is the continued use of the 
tooth-brushes commonly found in the markets to 
induce inflammation of the gums, and consequent 
decay of the teeth. How often does the Dental 
practitioner hear the expression, " My teeth and 
gums never troubled me, until I began to take 
care of them by using the brush. 55 

Another, and the third error which appears in the 
case stated, is the unprepared and unsuitable con- 
dition of the dental organs at the time when the 
plugging operation is performed. This is frequent- 
ly attended to under very improper circumstances, 
when all that is done only serves to increase the 
existing irritation, and hasten the period of their 
destruction. But to this I shall refer hereafter. 

I repeat it again, the public needs very much to 
be informed on this subject, which has for its 
object the prevention of disease, and the remedial 
treatment of the organs which were evidently de- 
signed to perform so essential a service in main- 
taining the health and comeliness of the human 
structure. 

The causes which act upon the dental organs to 
induce disease, and destroy them, should be studied 



24 INTRODUCTORY REMARKS. 

and thoroughly understood by all, as the interests 
of all are, to a greater or less extent, involved. 

There seems to be an impression abroad, that 
the teeth, unlike other constituents which make up 
the human form, are transitory in their nature ; or, 
rather, that they are rendered so by influences 
which lie beyond the reach of remedies, and which 
science nor art can control. That multitudes of 
teeth suffer premature decay in relation to the 
general structure, can not bo denied ; but why 
should the dental organs form so striking an ex- 
ception % Why should these organs be doomed to 
destruction, while the health of the other members 
of the organization remains unimpaired? If obe- 
dience to the laws which control the health of other 
parts of the physical system secure, in any degree, 
their exemption from disease, why may not a like 
obedience, in regard to these organs, conduce to 
the same end? There is, indeed, no reason to 
suppose that such is not the case. But, on the 
other hand, there are a variety of facts which 
clearly demonstrate that these organs may be 
rendered almost entirely free from the influence of 
noxious causes. The teeth, as other members of 



INTRODUCTORY REMARKS. 25 

the physical structure, are subject to disease ; but 
there can be no doubt but, by the application of 
proper means, they may be rendered as free from 
noxious influences as the eye, the ear, or the hand. 
What parent would expect his child to attain to 
manhood, entirely neglected from infancy in regard 
to cleanliness ; living in filth — no ablutions to the 
body — no change of linen from week to week, and 
month to month? Would he not reasonably an- 
ticipate disease to be engendered, the constitution 
undermined, and, if death did not prematurely su- 
pervene, at least an enervate, invalid, and suffering 
body % Can an individual live in the habitual vio- 
lation of the laws of his being, and expect to go 
unpunished? If there is no attention paid to 
cleanliness of the mouth ; if particles of food are 
allowed to accumulate about the teeth, and remain 
there to putrefy, and generate a pungent acid, so 
acrid as to excite inflammation in every living part 
with wilich it long remains in contact ; if, from 
these, the gums and teeth become diseased, and if, 
in the application of remedies, a mistaken appre- 
hension of their modus operandi leads to the em- 
ployment of those which only serve to increase the 



26 INTRODUCTORY REMARKS. 

mischief already begun ; if these are circumstances 
which appertain in some degree to a large majority 
of individuals who make up the community, is it 
at all strange that dental diseases, and consequent 
affliction, should so extensively prevail? 

The All-wise Creator has established rules for 
the regulation of all organized, animate as well as 
inanimate, matter, which can not be disregarded 
with impunity. He has endowed man with intelli- 
gence — with faculties capable of comprehending 
his own necessities, and, when properly directed, 
of providing for all his physical wants. He has 
also enjoined upon him certain moral duties. It is 
required that the mind which is given him should 
be exercised for his own best interests, present as 
well as future. It therefore becomes his duty to 
study to obtain a knowledge of the laws which 
govern his physical existence, and, by all the means 
within his reach, endeavor to avoid the dangers 
which beset him on every side ; to select those 
truths which the light of science and experience 
enable him to cull from among the errors which 
surround him, and which, in the case under con- 
sideration, may be an unerring guide to the indi- 



INTRODUCTORY REMARKS. 27 

vidual, and procure for him the realization of the 
saying of the wise man, that " So shall the knowl- 
edge of wisdom be — when thou hast found it, then 
there shall be a reward, and thy expectation shall 
not be cut off." 

The rules of practice in relation- to the organs 
under discussion are few and simple, and easy of 
application ; and as they shall come to be generally 
understood and applied, the evils which have their 
origin in dental diseases will proportionately di- 
minish, although perfect exemption may never be 
attained. 

To place within the reach of every one com- 
posing the millions of the country, the knowledge 
which is deemed of so much importance to their 
welfare, the publication of this little manual has 
been undertaken. The design of the author is, to 
set before the common mind, in a clear and com- 
prehensive form, the general principles of dental 
science and art, so far as they can be of general 
practical utility, divested of all useless techni- 
calities ; to exhibit the true causes of dental dis- 
eases — both natural and artificial — their mode of 
operation, and the results to which they lead, and 



28 INTRODUCTORY REMARKS. 

to point out the necessary prophylactic and reme- 
dial means which science and experience furnish. 

In order to accomplish this responsible task, the 
published writings of most of those who have made 
this subject their study have been extensively con- 
sulted ; which, with an extensive practice, both 
medical and dental, extending through a period of 
some seventeen years, inspire the author with a 
degree of confidence, if not in his ability to render 
the subject entertaining and attractive, at least in 
the truth of the deductions which he has made, 
and the efficiency of the practice he recommends. 



ENEEAL ANATOMY. 29 



THE GENERAL ANATOMY AND ARRANGEMENT OP 
THE HUMAN TEETH. 



GENERAL ANATOMY. 

The teeth of the human subject may be defined 
as distinct organs, of a bony structure, set in bony 
sockets, and, designed by the Creator to perform a 
special office. 

Each tooth is anatomically divided into the body 
or crown, and the fang or root. In its natural po- 
sition, the root is that portion of the tooth con- 
tained in the bony socket of the jaw; and the 
body or crown that which rises above the gum, 
and which consists of two parts — the bony struc- 
ture, and a thin layer investing it, which is much 
more dense and hard, called the enamel. The 
part w T here the crown and root unite, is called the 
neck. 

A thin, fibrous membrane surrounds the root, 
commencing at the termination of the enamel or 
neck, and extending to the extremity. The socket, 
also, formed by the jaw-bone, is lined by a corre- 



30 



GENERAL ANATOMY 



sponding one. The surfaces of these membranes 
are in close contact with each other, but when in 




a state of health have no direct vascular or nerv- 



GENERAL ANATOMY. 31 

ous connection between them ; but in a state of 
disease, when they become inflamed, an adhesion is 
sometimes formed, which renders them more diffi- 
cult to extract, although the resistance is not much 
increased. Dentists sometimes, however, when by 
mischance in removing a tooth from its position 
they fracture its socket, refer to an osseous or bony 
union between the tooth and its socket, as the cause 
of the accident. But this reason is always cited 
in order to extenuate an unskillful performance. 
I do not assert that such a circumstance never 
transpired ; but I have extracted many thousands 
of teeth, and have never yet met with an instance 
of the kind, where the root of a tooth was con- 
solidated with its socket. A small orifice at the 
extremity of each root permits the nerve and 
blood-vessels to pass. This hole extends through 
the root, gradually enlarging as it approaches the 
neck, and terminates in a sinus or sudden expan- 
sion in the body of the tooth. The form of this 
cavity corresponds very nearly with the external 
surface of the tooth. This 'cavity is filled with a 
pulpy substance, very vascular, and extremely 
sensitive. This is what is commonly called the 



32 



GENERAL ANATOMY; 



nerve of the tooth. It consists of the expanded 
nerve and blood-vessels, filling perfectly the cavity 
it occupies, and is closely attached to its Avails. 
From this source the tooth receives its nourishment 




NERVOUS CONNECTION OF THE TEETH. 

and sensibility. Destruction of this nervo-vascular 
substance by artificial means, is what is understood 
by dentists when they talk about killing the nerve 
to take away the sensitiveness of the tooth, in order 



GENERAL ANATOMY. 33 

to preserve it by filling its cavity, when caries has 
penetrated to its sensitive part. Destruction of 
this nerve will effectually remove all sensibility of 
the tooth, but it also as completely destroys its 
vitality. 

Each tooth has attached to one side, at its neck, 
a small ligament, which is also attached to the 
edge of its socket. It is called the Ligamentum 
Dentis, and is seemingly designed to retain the 
tooth in its position ; for this is really the only 
attachment which secures it in its natural position ; 
and if it were not for the uneven surface of the root, 
and its incasement in a bony socket, there would 
be offered, aside from this, but very little resist- 
ance to its removal. This ligament was but recently 
discovered, which evinces the neglect which the 
teeth have formerly received from anatomists and 
others engaged in their investigation. When the 
discovery of this ligament was made, a few years 
since, it was said that the excision of it would 
enable the dentist to remove teeth without pain, or 
much effort. But the resistance which it offers is 
very inconsiderable, and in the operation of ex- 
tracting is trifling indeed, 

2* 



34 CHEMICAL COMPOSITION. 

CHEMICAL COMPOSITION. 

In chemical composition, the relative proportions 
of the constituent principles which compose these 
organs vary according to circumstances. The 
enamel differs very much from the portion which it 
covers, and also from the root, and all change with 
the age of the individual. The teeth are consti- 
tuted of a calcareous or limy substance, and animal 
matter. The proportion of animal matter decreases 
as age advances. Thus, according to the analysis 
of an eminent chemist, the bony part of the tem- 
porary teeth consists of 68 parts of phosphate and 
carbonate of lime, and 32 parts of animal matter, 
in every 100 parts ; and the bony portion of adult 
teeth, of 70 parts of the earthy salts, and 30 parts 
of animal matter. Also the enamel consists of 84 
parts calcareous, and 16 parts of animal substance 
in every 100 parts. 

It will be noticed that the proportion of animal 
matter is greatest in early life. It will be borne 
in mind, also, that in proportion to the animal 
substance is the vitality of the teeth, and their 
power to resist chemical action. But as the pro- 



FORM, NUMBER, ETC. 35 

portion of animal substance decreases, is their 
liability to inflammation. Hence, it is observed, 
that the chemical agents which come in contact 
with these organs during childhood, excite inflam- 
mation ; whereas, as age advances, inflammation is 
less liable to occur, until, at middle life, they 
operate almost exclusive^, so far as the structure 
of the teeth is affected, by direct chemical action. 
This subject will be more fully explained hereafter. 

FORM NUMBER, AND ARRANGEMENT. 

The form of the teeth depends upon the position 
and special office they are designed to perform. 

The Incisors, or cutting teeth, so named from 
their flattened wedge shape, and the office they 
perform,- are eight in number, four upper and four 
lower, and occupy the front position. They have 
but one root each, which is of a rounded form. 
The body of the tooth, which is covered with enamel, 
is of a wedge shape. 

The next in order are the Cuspids, or, as they 
are commonly called, eye teeth. They are four in 
number, two upper and two lower. The root of 



36 FORM, NUMBER, ETC. 

the eye tooth is similar in form to the incisors, but 
is somewhat longer and larger, and a little more 
tapering in proportion to its size. The crown, or 
enameled portion, terminates in a point. From 
this circumstance it derives its name, Cuspis, signi- 
fying a point. In regard to extracting this tooth, 
there is a general impression that there is more 
danger than in removing the ofhers. Many have a 
sort of superstitious fear that the eye will become 
affected, supposing it to have a particular connection 
with that organ. I have known many persons to 
suffer very much from disease of these teeth, from 
this superstitious dread of having them removed. 
But such apprehensions are entirely without founda- 
tion. This tooth may be as easily extracted, and 
with as little danger of subsequent difficulty arising 
from it as any other one, with a suitable instrument 
and a skillful hand. 

The next in order of the adult teeth are the Bi- 
cuspids^ which name signifies two points. They are 
eight in number — four superior, and four inferior. 
These teeth commonly have but one root each, but 
sometimes two. They occupy a position next poste- 
rior to the cuspids or eye teeth, and take the place 



FORM, NUMBER , ETC. 37 

of the molar, or grinding teeth, of the deciduous or 
temporary set. The first, or deciduous incisors, and 
eye teeth, correspond in form, number, and position 
with the secondary, or permanent ones. There are 
eight molars of this set. Of the temporary teeth, 
there are but twenty. Hence, there are no teeth 
of the deciduous set corresponding with the bi- 
cuspids of the permanent ones. The bi-cuspids 
occupy the place of the deciduous molar teeth, 
and hence the molar or grinding teeth of the 
permanent set have a position posterior to the 
deciduous ones. The molar teeth of this set are 
twelve in number, making the permanent set of 
teeth to consist of thirty-two when complete 

The first, or anterior molar teeth, make their 
appearance behind the temporary set quite early, 
usually at from five to seven years, and before any 
of the first set fall out. The second molar makes 
its appearance much later in life ; and hence the 
mistake which is frequently made, by supposing 
the first permanent molar to be of the temporary 
set. This is an important fact, worthy of remem- 
brance ; for a general knowledge of what is here 
stated, would have saved multitudes of teeth. As 



38 THE FIRST DENTITION. 

little attention is paid to the first set of teeth, 
being considered of short duration, so this one is 
suffered to decay from sheer neglect, even in cases 
where much anxiety and care are manifested in the 
preservation of the permanent set. Often, when 
called upon by parents to extract this tooth for 
their children, have I witnessed their surprise, on 
being informed that it was not of the deciduous 
set, and would not be replaced. 

The molar teeth differ in form very much from 
any of the others, the lower ones having two roots, 
and the upper ones three. Each of these roots has 
its distinct nerve and blood-vessels passing through 
it, from its extremity to the body of the tooth of 
which it forms a part, where they unite in forming 
the pulpy expansion of that part. 

THE FIRST DENTITION. 

The deciduous, or milk teeth, as they are some- 
times called, as has already been stated, are twenty 
in number. The age at which they first make 
their appearance varies considerably, and generally 
without any apparent cause for it. Ins ances are 



THE FIE ST DENTITION. 39 

not wanting, in which children have been born with 
two or more teeth; while in many other cases, 
they have not come through the gum until fourteen 
or sixteen months, or even as late as two or three 
years. In general, however, dentition may be said 
to commence at the age of from five to eight 
months, and usually proceeds in the following order, 
the low^er almost always preceding the upper for a 
longer or shorter time : — The four central incisors, 
at from 5 to 8 months ; the four lateral incisors, 
at from 7 to 10 months ; the four anterior molars, 
at from 12 to 16 months ; the four cuspids, or eye 
teeth, at from 11 to 20 months ; the four posterior 
molars, at from 18 to 36 months. These periods, 
however, are given only as a general rule, liable to 
frequent exceptions, not only in the time at which 
the different teeth appear, but also in the relative 
order of their precedence. 

The bodies of the deciduous teeth are not as 
large as the permanent ones, nor their roots as long. 
The process by which the deciduous teeth are re- 
moved, to make room for the permanent ones, is a 
natural one. True to her purpose, when the 
pi oper time arrives, Nature proceeds to remove the 



40 THE FIRST DENTITION. 

roots of these teeth by the process of absorption. 
When there is no interruption of this process, the 
entire roots are removed, leaving nothing but the 
crown, which falls off, rendering it complete. 

The process of removing the first set of teeth 
by absorption is a very intricate one, and many 
wonder on account of it. Most persons who have 
never investigated this subject, entertain the idea 
that the milk teeth have little, or no roots at all. 
Having noticed their own, perhaps, when they fell 
out, they come to the conclusion that all are alike, 
and having no knowledge of the absorbent process, 
suppose that roots were never attached to them. 
But the size of the roots of these teeth bears a 
similar proportion to their sockets as do those of 
the adult teeth to theirs, and the difficulty of ex- 
tracting them w T ould be equally as great, were not 
the bony structure of childhood more elastic and 
yielding than at adult age. But they are entirely 
removed by absorption, when Nature is not diverted 
from her purpose. It is a vital process. The same 
energies which gathered up the material of which 
bone is composed from the circulating pabulum of 
the body, and deposited the temporary roots in their 



THE FIKST DENTITION. 41 

sockets, in order to make room for another and a 
permanent set, gathers them up again, and by a 
similar process removes them out of the way. And 
this is called absorption of the roots of the de- 
ciduous teeth. The bony sockets of the permanent 
teeth are frequently removed by a similar process, 
although a diseased one. 

Previous to the appearance of the temporary 
teeth through the gums, their germs, with those of 
the permanent set, exist imbedded in their sockets. 
Each permanent tooth exists in connection with its 
corresponding temporary one, or rather seems to 
spring from it, and is attached to it. This at- 
tachment continues until, in the process of develop- 
ment, the permanent tooth acquires a condition to 
allow of its separation. It is impossible to tell, 
from the appearance of the deciduous teeth, or any 
other indications, at precisely what time this sepa- 
ration takes place, but it does not take place until 
near the commencement of the absorbent process 
upon the deciduous roots. This is an important 
fact, well worth remembering', and one which is 
particularly interesting to those who have the care 
of children. 



42 THE FIRST DENTITION. 

In the operation of all natural causes which 
develop and perfect the physical organization, any 
infringement of the organic laws tends to deformity. 
It is particularly so in the development of the den- 
tal organs. The connection which exists between 
the temporary and permanent teeth can not be dis- 
turbed with impunity, until the order of Nature 
has so determined. Whenever, therefore, one of 
the milk teeth is removed from its socket by acci- 
dent or otherwise, and the attachment of the gum 
of the succeeding tooth is broken up too soon, more 
or less injury, or perhaps entire destruction of it, 
is the consequence. There are frequent occurrences 
of this kind. The temporary teeth are frequently 
extracted under the impression that they will in 
due time be replaced. I have seen many cases 
where this operation had been untimely performed, 
where destruction of the secondary teeth had 
been the result. One case came under my notice 
where the untimely removal of all the deciduous 
teeth on the lower jaw, except the two central 
incisors, entirely destroyed the corresponding germs 
of the permanent ones, and this was done by a 
practitioner of medicine of considerable standing. 



THE GUMS, ETC. 43 

Those who have the care of childhood, therefore, 
should bear in mind the results which follow the 
too early removal of the temporary teeth, and 
should never allow of their extraction, except in 
extreme cases, unless there is unmistakable evi- 
dence that the danger referred to is past. The 
circumstances involving the particular case, will 
generally determine with sufficient plainness to 
enable any one qualified to perform this operation, 
to decide in regard to it. 



THE GUMS, OR PARTS CONTIGUOUS 
TO THE TEETH. 

The gums, or soft fleshy parts which cover the 
sockets of the teeth, have no direct attachment to 
the teeth themselves. Each tooth is surrounded 
by it at its neck, and is in contact with it, but it 
may be pressed away from the tooth down to the 
bone, with which it is united. The margin of the 
gum, therefore, is free about the teeth, and allows 
of the lodgment of particles of food between them, 
and also of chemical agents which affect them more 
or less injuriously. The construction of the gums 



4:4 TnE GUMS, ETC. 

and teeth, and their arrangement in relation to 
each other, deserves to be well understood. It is 
the general impression that the gum is attached to 
the teeth, and dentists and physicians who extract 
these organs, are in the practice of cutting around 
them in order to facilitate their removal. A gum 
lancet has always been considered an indispensable 
instrument of the dentist's case, and the medical 
practitioner who appears abroad without his pocket 
knife, is deemed entirely unprepared for all the 
emergencies of his position. Cutting around the 
tooth has always been considered a prerequisite to 
its extraction, and whenever a mishap has occurred 
in the operation, it has been ascribed to the neglect 
of properly cutting the gum. If the tooth was 
very hard to remove, and very painful, it was not 
sufficiently loosened by cutting the gum. If the 
gum was lacerated in the operation, and such acci- 
dents are sometimes extremely tedious to bear, the 
patient consoles himself with the censorious re- 
flection, that if the gum had been entirely cut 
loose from the tooth, the difficulty would not have 
happened. 

It is strange, indeed, that such a custom should 



THE GUMS, ETC. 45 

so universally and so long prevail, where such im- 
portant interests are involved. Universally there 
is a dread of the pain produced by the removal of 
a tooth, but generally there is more pain realized 
in the operation of cutting the gum than extracting 
the tooth ; at all events it is frequently so. How 
often is the remark made by individuals, in antici- 
pation of the removal of a tooth, that "if it were 
not for the cutting the gum, I should not mind it." 
And yet, no possible benefit can accrue from this 
operation. It is, to say the least of it, entirely 
useless. It is frequently decidedly injurious. If 
there is no attachment between the gum and the 
tooth, what necessity can there be for cutting the 
gum ? Certainly none at all. But whenever the 
gum is lacerated, it will be found that the edge 
of the bony socket is fractured off, which, ad- 
hering to the tooth, takes a portion of the gum, 
with which it is connected, with it. When a lancet 
has been passed around a tooth, making an incision 
in the gum down to the bone a little distance from 
the tooth, as is commonly the case, the portion so 
removed from the main gum is very liable to be 
removed with the tooth, with the portion of bone 



46 CAUSES OF INJURY, ETC. 

to which it is attached. This result very fre- 
quently follows when the common instrument, the 
turnkey, is used. Laceration of the gum need 
never occur on the removal of a tooth with the 
forceps, where it is not subjected to the lancet, if 
the operation is dextrously performed. All that 
is ever necessary previous to applying the extracting 
instrument, is to press the gum away from the 
tooth with any instrument suited to the purpose, 
in order that the extracting forceps can pass up so 
as to clasp the neck of the tooth. If the gum is 
not inflamed and sensitive, it will cause no pain, 
but every advantage will be thus obtained. 

Having given this general view of the structure 
of the teeth, and parts contiguous to them, I 
proceed to consider, briefly, the 



CAUSES WHICH AFFECT THEM INJU- 
RIOUSLY, AND THEIR MODES OF 
OPERATION. 

The causes that act upon the dental organs 
injuriously are few and simple, and easy to be 
understood. But it has been truly said, that, that 



TEETHING, ETC. 47 



with which the world is most familiar, it least 
understands. The fact that certain causes affect 
the teeth, and that the habits of individuals are 
such as to allow them their full development and 
force, is the main reason why those causes have not 
been properly considered and rightly understood. 
They have become so familiar that they do not 
impress the mind or excite [the attention, and 
therefore they are generally almost entirely over- 
looked. When they shall become thoroughly and 
generally understood, and the proper means adopted 
to prevent their injurious effects, the labors of the 
dental profession no doubt will, to a very great 
extent, be dispensed with. That there are means 
which are available and efficient to this end, I shall 
endeavor to demonstrate. 

TEETHING, OR THE FIRST DENTITION. 

The time which generally first demands the 
attention, and at which the operation of some 
of the various causes begin to exert their in- 
fluence, is that period of infancy in which the 
first dentition, or teething, takes place. This is a 



48 ' TEETHING, ETC. 

very interesting period to those who have the care 
of childhood — to parents and guardians — and their 
attention is generally called to the consideration of 
the dental organs, but in other respects than as 
regards the influence which their condition may 
exert upon the welfare of these organs in after 
life. The time of teething is a critical point of 
childhood. It is not my design, however, to enter 
into a discussion of this subject, for to enter upon 
a history of the consequences which result from 
the irritation of teething, were to treat generally 
of all the diseases of infancy ; for there is scarcely 
an ailment to which this period of life is subject, 
which is not at times produced, or at least aug- 
mented, by this cause. It is sufficient for my 
purpose simply to state that there frequently re- 
mains, after the first dentition is complete, an 
irritable condition of the teeth and gums, as the 
consequence of that process, which being allowed to 
continue, affects, in some instances, very seriously 
the deciduous teeth, and the germs of the perma- 
nent ones attached to them. The unhealthy state 
of these organs here referred to would generally 
subside spontaneously, however, were it not that 



TEETHING, ETC. 49 

other noxious agents were brought to act injuri- 
ously upon them. As I have already stated, there 
is generally but very little attention paid to the 
condition of children's teeth and gums, previous to 
the falling out of the first set, unless attended by 
painful disease ; the prevailing impression being, in 
regard to them, that they exert but little or no 
influence beyond their own time of duration. 
Hence, under ordinary circumstances, there is no 
thought directed to these organs in reference to 
their cleanliness, or even to their decayed con- 
dition, except the complaints of the little sufferers 
awaken sympathy, and thus induce momentary 
attention ; and hence the many aches and pains, as 
the toothache and the earache, which are incident 
to childhood. Nearly all of them have their origin 
in the neglect of the proper means necessary to 
the cleanliness of these organs. From the time 
that the first dentition is complete, until the in- 
dividual approaches puberty, and the permanent 
teeth — all except those called the wisdom teeth — 
are perfectly formed in their sockets, no attention 
at all, with now and then an exception, is given to 
the condition of these organs. But it will be re- 

3 



50 TEETHING, ETC. 

membered that the same causes_, with one exception, 
which act upon and destroy the teeth at a later pe- 
riod, exert their energies upon them during this time 
also. And it is at this time of life, in most cases, 
that the seeds of dental disease are sown. It is, 
therefore, just as necessary that means should be 
used to protect the dental organs against the in- 
fluence of certain morbid agents, which, without 
proper protection, will produce the result which 
has become so general, as it is that the body should 
be guarded against the various causes which tend 
to its destruction. The miasmatic exhalations of 
the fenny marsh, or the damp and chilly changing 
winds of autumn, are not more certain to engender 
disease of the human constitution when brought to 
bear with full force upon it, than are the noxious 
agents developed by the putrefactive decomposition 
of substances which find a lodgment about the 
teeth and gums, when, for the want of the proper 
detergent means, they are allowed to spend their 
energies upon these organs in their irritable con- 
dition, which teething generally produces. What 
I wish to impress upon the mind of the reader 
here is, the fact that the main, immediate cause 



TEETHING, ETC. 51 

of dental disease consists in the irritation and 
direct decomposition of the substance of the teeth, 
by irritating chemical agents, which, are generated 
by the putrefactive decomposition of particles of 
food, resulting from the want of proper cleanliness ; 
and that this cause acts both upon the deciduous as 
well as upon the permanent teeth, and that, in a 
greater or less degree, the impression produced 
upon the first is extended to the second ones. All 
other local causes are secondary to this. Let the 
proper means be adopted to prevent the operation 
of this cause, and let those means be timely applied, 
and ninety-nine hundredths, at least, of the teeth 
which, under present circumstances, prematurely 
decay and are destroyed, would remain co-extensive 
W T ith other parts of the physical organization. 

The causes which affect the teeth injuriously are 
of two kinds — those which affect them through the 
medium of the general system, and those which 
act directly upon the substance of the teeth, either 
by inducing inflammation and consequent mortifi- 
cation, or by direct chemical action, effecting de- 
composition. 

The first of these may be denominated predis- 



52 TEETHING, ETC. 

posing causes, for without the accession of others 
permanent injury of the teeth would seldom occur. 
Any active agent, which induces general irritation 
of the whole physical system, and particularly of 
the dental organs, is of this class of causes. But 
I refer more particularly to those general irritating 
causes which, while they act generally, exert a 
specific influence upon the dental organs. 

Dentition, both the first and second, may be 
considered as belonging to this class of predis- 
posing causes, and holding the first rank. The 
various mercurial preparations which are used in 
medicine, also belong to this class, and these are 
the only ones of sufficient importance to require 
particular notice. 

The causes which affect the dental organs by 
direct local action, by inducing inflammation and 
its consequences, or by direct chemical process, and 
which demand special consideration, are — first, the 
acid or chemical agent produced by the putrefactive 
process, and which is generated to a greater or 
less extent in all cases. Secondly, the tartar 
which is deposited upon the teeth, and becomes a 
source of disease ; and thirdly, the improper use 



CAUSE OF CARIES. 53 

of remedies, and the use of improper remedies. 
These form quite an extensive class of causes. 
They consist of the tooth-brush, of various prepa- 
rations as dentifrices, of filing the teeth, and also 
of plugging them, etc. 

The above are the mam causes which affect the 
dental organs, and tend to destroy them, and which 
it is deemed of importance to be well and generally 
understood. To these, as involving the general 
pathology of the teeth, the attention is now called. 



DENTITION AS A PREDISPOSING 
CAUSE OF CARIES. 

That there is, generally, during the first denti- 
tion, more or less general irritation of the system, 
and local irritation of the organs connected imme- 
diately with the teeth of children, is a fact too well 
known to require any further argument for its es- 
tablishment, than the simple statement that it is so. 
In many cases, extreme irritation and inflammation 
of the gums take place ; but in all cases, even 
where teething is effected in its most natural and 
perfect manner, there is more or less irritation of 



54 CAUSE OF CARIES. 

the gums during the process ; and generally, at this 
day, children are so accustomed to confectionery, 
and consequent stomach ailments, that there are 
very few who complete the process of dentition 
without an irritable or inflamed condition of these 
organs remaining as the consequence. 

The irritable state of the teeth and gums result- 
ing from the first, as well as the second dentition, 
would, in nearly all cases, subside spontaneously, 
if other causes were not brought to act in con- 
junction with it. But in addition to the predis- 
position to disease already existing as above stated, 
other and more potent causes are allowed to exert 
their influence — to continue, and frequently aug- 
ment the common evil, until, as a general thing, 
caries, and consequent destruction of the teeth, 
follows. 

There are other predisposing causes which 
frequently contribute, with that of dentition, to 
produce the condition referred to; but it is not 
necessary to refer to them here, as the general 
principle is comprised in the facts already set 
forth. My object is mainly to impress upon the 
minds of those who have the care of infancy and 



CHEMICAL AGENTS, ETC. 55 

youth, the fact that there is a predisposition to 
dental disease induced by certain causes at the 
periods referred to, and that hence the importance 
of using those means necessary to prevent the ac- 
cession of other causes, which, when allowed to 
exert their united influence, are productive of so 
much evil. 



CHEMICAL AGENTS — THE RESULT 
OF PUTREFACTION. 

It has already been observed, that those having 
the care of children usually pay little or no regard 
to the condition of the organs under consideration, 
after the first dentition is accomplished, provided 
there is no uncommon manifestation of disease. 
The child is allowed to pass on from year to year, 
without ever once, perhaps, having had applied any 
detergent means, so essential to the health of the 
teeth and gums. The food is allowed to accumu- 
late about the teeth, and at this period the gums 
are usually more or less tumid from the effect of 
dentition, and serve especially as a lodgment to 
particles of food. Vegetable and animal sub- 



56 CHEMICAL AGENTS, ETC. 

stances, allowed to accumulate and remain in a 
fixed point, and combined with a certain degree of 
heat and moisture, undergo what is called the pu- 
trefactive fermentation, resulting in the production 
of gaseous substances, which act, by their pun- 
gency, upon the organs with which they come in 
contact. It is not necessary, here, to go into a 
discussion of this subject, for the purpose of 
proving out the specific composition of the dele- 
terious agent or agents developed under such cir- 
cumstances ; it is sufficient for all practical pur- 
poses, to know the fact that there is an acid 
substance produced, which not only irritates and 
inflames the gums and sensitive portions of the 
teeth with which it comes in contact, but also acts 
by producing direct chemical decomposition of the 
enamel of these organs. That such is the case, is 
susceptible of demonstration. Any one may satisfy 
himself of this, by the examination of his own 
teeth. Offensive breath, with most persons, arises 
from this cause. A diseased throat or lungs may 
have this effect, by the putrid effluvia which is ex- 
haled from them ; but these are exceptions. The 
mass of people are not so unfortunate as to be 



CHEMICAL AGENTS, ETC. 57 



subject to these afflictions. But where cleanliness 
of the teeth is neglected, there is a tainted breath. 
There are no exceptions. Every individual, what- 
ever his general health may be, who neglects to 
apply proper detergent means to his mouth, as 
containing the dental organs, subjects himself in 
some degree to the evils which arise from the pu- 
trefactive decomposition of alimentary substances ; 
the intensity, only, being modified by circumstances. 

Childhood and youth, owing to the want of 
proper attention, are the periods particularly ob- 
noxious to the operation of this cause. From the 
effect of dentition, the gums are generally more or 
less swollen and irritable, and more especially 
during and immediately subsequent to the second 
dentition. During this period, the food more 
readily finds a lodgment about the teeth. 

It is well known that animal and vegetable sub- 
stances in combination, when placed under certain 
circumstances, undergo the putrefactive fermenta- 
tion. It is well known, also, that an acrid chemical 
agent is the result of this process ; and it will be 
readily seen, that the condition in which alimentary 
substances are placed, when lodged about the 

3* 



58 CHEMICAL AGENTS, ETC. 

teeth, is favorable to this process. It may be 
fairly inferred, therefore, that this corroding agent 
would be developed, and that inflammation of the 
gums and teeth, as well as direct chemical decom- 
position of certain portions of the latter, would be 
the result. Such, indeed, experience proves to be 
the case. Irritation and inflammation of the gums 
and parts of the teeth not covered with enamel, 
which are exposed to its influence, are always 
present in some degree, where there is no attention 
paid to cleanliness. The teeth always commence to 
decay at such points as are most exposed to the action 
of this corroding agent generated by putrefaction. 
Those teeth which present the largest contact 
surfaces, and which are in other respects so located 
as to expose them to the constant contact of putrid 
particles, are always the first to be affected with 
disease. On the contrary, the polished surfaces 
of teeth are the last to become carious. Indeed, 
where they are kept perfectly free from the action 
of corroding substances by cleanliness, they never 
decay. As, for instance : their labial and lingual 
surfaces seldom arc the seat of caries, and never, 
except when a natural depression, or other defect, 



CHEMICAL AGENTS, ETC. 59 

is present, or perfect neglect of cleanliness affords 
a lodgment for putrid particles upon them. Teeth 
which, from their natural position, or from acci- 
dent — as the extraction of an intermediate tooth — 
stand sufficiently asunder to prevent the lodgment 
of particles of food upon them, very seldom decay 
at all. The observation of this fact probably sug- 
gested the pernicious practice of separating teeth, 
though sound, with a file, when close together. 

It is evident, therefore, when, from dentition or 
other predisposing causes, the gums are swollen, 
and, with the teeth, are excited to an undue de- 
gree — as they usually are, especially at. the time, 
and immediately subsequent to the second denti- 
tion — that if, under these circumstances, cleanliness 
be neglected, a new and potent cause of disease 
will necessarily supervene, and disease of the teeth 
will be the necessary consequence. 

I have stated that the period at, and immediately 
succeeding, the second dentition, was that most 
favorable to the development of causes which tend 
to the destruction of the teeth. It will be found, 
on close observation, that in a great majority of 
cases where these organs become diseased, the 



60 TARTAR. 

time of its commencement is referable to this pe- 
riod. From what has been stated, the reason will 
appear obvious. 

At this time, also, of the second dentition, or 
about the age of from twelve to fifteen years, an- 
other cause begins to operate in conjunction with 
those which have been referred to, and, in many 
cases, adds very much to the potency of these 
evils. I refer to the substance commonly called 

TARTAR. 

This substance exists in solution, or suspended 
in the saliva, and is deposited from it upon the 
teeth. When first deposited upon them, it is in a 
soft and cheese-like state, and is easily removed ; 
but it soon hardens, and frequently becomes so 
indurated, when allowed to remain, that it nearly 
equals, in this respect, the tooth on which it is 
deposited. In its composition, it resembles some- 
what that of the teeth. It is composed principally 
of the carbonate of lime. I am not aware that 
this substance exerts any direct injurious influence 
upon the teeth upon which it is deposited ; but, in 



TARTAR. 61 

some instances, seems to serve as a protection to 
them from other causes. But, as this substance is 
generally deposited, first of all, at the necks of the 
teeth, and especially underneath the free edge of 
the gum, it thus presents a rough surface to that 
structure, and also affords a lodgment to putrid 
particles, and other corroding agents. Its first 
effect, therefore, is to excite more or less irritation 
of the gum, producing increased redness and sensi- 
bility, with sponginess, and the separation of its 
edge from the necks of the teeth. As this accu- 
mulation ircreases, the effects keep pace with it. 
The gum generally becomes exceedingly painful, 
as this and other causes combine to operate upon 
it, so as to render the ordinary operation of brush- 
ing the teeth almost impracticable ; and thus, by 
inducing a neglect of the common means of pre- 
venting its accumulation, it becomes the unavoid- 
able cause of its continued increase. Absorption 
of the gum and alveolar process, or bony sockets 
of the teeth, is the next consequence, which 
gradually goes on until the teeth, losing their sup- 
port, become loosened, and at length fall out. 
A temporary and fallacious support is sometimes 



62 TARTAR. 

produced by a large quantity of tartar, which forms 
one continuous mass around the loosened teeth ; and 
instances have occurred in which several teeth, thus 
cemented together, have come away without being 
separated from each other. 

The lower front teeth are more particularly 
liable to this concretion than any others ; and 
hence it happens that, although these teeth, owing 
to their form and position, are attacked with caries 
far less frequently than others, yet there are scarce- 
ly any teeth which are so commonly lost as these. 

Accumulations of this limy substance are seldom 
found on the temporary teeth. Usually, it is not 
noticed until about puberty, or till the fourteenth 
or sixteenth year. It would seem that the growth 
of bones during childhood and youth requires all 
that the system can supply of earthy matter, for 
that purpose. The saliva of the adult, however, 
always contains it in a greater or less degree ; and 
hence, where there are no means adopted for the 
purpose of preventing its accumulation, it will 
always be found in some quantity about the teeth. 

In regard to the nature and source from whence 
this substance comes, generally there is but very 



TARTAR. 63 

little knowledge. I have been surprised at the 
ignorance sometimes manifested by men, in other 
respects of general intelligence, but of this sub- 
stance having no definite idea, notwithstanding 
their health and comfort were so intimately con- 
nected w T ith it. Cases are frequently met with, 
where the tartar, by becoming detached in scales 
from the teeth, has led the individuals to suppose 
the teeth themselves to be crumbling to pieces. 
In all cases where this substance is allowed to 
accumulate, other causes, which have been referred 
to, are, as a necessary consequence, allowed to act 
in conjunction with it ; for the most proper means 
to be adopted as a remedy for this evil, are equally 
so for the others. The means, then, by which the 
formation of this substance can be obviated, or at 
all events its accumulation prevented, becomes a 
matter of no small importance. When this con- 
cretion has become indurated, and attached to the 
teeth, it can not be removed except by instruments 
adapted to the specific purpose. The operation by 
which this end is accomplished, is termed scaling 
the teeth. To this, as a remedy, I shall have oc- 
casion to refer hereafter. 



64 TAKTAK. 

In regard to the causes of dental disease which 
have been discussed, it will be observed — that 
dentition, in most cases, leaves the gums and teeth 
in an irritable or inflamed state ; that this con- 
dition would generally subside naturally and spon- 
taneously, did not other causes supervene. But 
this condition predisposes to disease of the teeth ; 
and, being thus exposed, the corroding agent 
generated by putrefaction almost universally in- 
duces more or less caries of the temporary set. 
These teeth, as has been stated, are generally 
viewed as of little consequence, being of short 
duration. But this is a very great error. Important 
and lasting results may, and frequently do, depend 
upon disease of the first set of teeth. From the 
want of cleanliness which they sometimes suffer, 
disease, to a degree that destroys prematurely the 
connection which exists between the rudiments of 
the permanent teeth and the temporary ones, may 
occur, and thus a lasting injury be effected in the 
deformity or total destruction of one or more of the 
secondary .teeth. Numerous instances might be 
cited where injury done to the temporary teeth had 
produced deformity of the secondary ones, by in- 



TARTAR. 65 

terrupting the natural course of their development; 
and an instance came under my observation, where, 
by the premature extraction of the deciduous teeth 
of the lower jaw, the germs of all the permanent 
teeth which were attached to them, except the two 
central incisors, were entirely destroyed. These 
two were so far developed as not to be materially 
affected by the unnatural operation. 

But inattention to the temporary teeth is com- 
monly indicative of their treatment during ado- 
lescence. Usually the second dentition takes place 
under the unfavorable circumstances which have 
been stated, an<^fcw another important influence 
gradually supervenes, to increase the excitement 
and assist the general evil tendency. 

The deposition and concretion of tartar upon 
the teeth, in addition to the other active agents, is 
in most cases sufficient to effect, sooner or later, 
the destruction of the dental organs ; and hence it 
is, that during the period of adolescence the per- 
manent teeth almost universally become in some 
degree carious. 

It is not generally until the individual approaches 
manhood, that he is induced to resort to the de- 



66 TARTAR. 

tergent means necessary for the well-being of his 
teeth, unless the subject is forced upon his attention 
by the pain of disease at an earlier period. This, 
however, is often the case. But, with many indi- 
viduals, self-respect, as age advances, leads to the 
adoption of means by w T hieh the personal appear- 
ance may be improved ; and, as " a mouth without 
teeth is a mouth without charms," these organs 
receive an adequate share of attention. For va- 
rious reasons, therefore, after the second dentition 
is accomplished, the attention of individuals is 
turned to the consideration of these important 
organs. 

To cleanse and purify the teeth from the in- 
fluences to which they have been subjected during 
their long night of neglect, is generally the first 
idea that suggests itself to the individual, and is 
practically the first step usually attempted to be 
made in the process of prophylactic or remedial 
applications. To accomplish this desirable end, 
custom has given a sort of universal sanction to 
the use of a particular instrument. Hence, what- 
ever may be the condition of the dental organs at 
the time their claims are considered, whether in an 



THE TOOTH-BRUSH. 67 

advanced stage of disease, or comparatively healthy, 
the first, and frequently the only means resorted to, 
to improve their appearance or correct their diseased 
state, is the tooth-brush. 



THE TOOTH-BRUSH AS A CAUSE 
OF DISEASE. 

This instrument, as commonly obtained in the 
shops, is made from the ordinary hog's bristle. 
Probably not less than seven-eighths of those now 
in the markets of our country are thus composed. 
Indeed, they are too well known to require de- 
scription. When made of this material, they are 
generally stiff, and always harsh when applied to 
an inflamed or sensitive surface, such as the dental 
organs more frequently present. 

Subjected as the teeth are to the influence of 
the causes which have been briefly adverted to, it 
requires no argument to prove that the additional 
daily application of an instrument like the common 
tooth-brush would only serve to increase the ex- 
citement and accelerate the evil. Experience 
proves most unquestionably, that this instrument, 



^6& THE TOOTH-BRUSH. 

as it is usually constructed, does not accomplish, in 
a single particular, the object for which it is de- 
signed ; for its legitimate object is to remove from 
about the teeth the deleterious agents which have 
been described, and cleanse them from all im- 
purities. But the interstices between the teeth 
and about the free margin of the gum, so very 
essential in the detergent operation, can not be 
reached by it ; and hence it is, where individuals 
are assiduous in their attentions to these organs, 
using the brush daily, under the impression that 
they are doing all for their preservation that science 
or art can suggest, and yet are doomed to submit 
to the gradual encroachments of carious disease. 
The truth is, the real, active agent which corrodes 
and destroys the teeth, is not reached at all in most 
cases by this instrument ; but, so far as an effect is 
produced by it, it tends to augment the evil. 

The remark is often made, that dental disease 
arises from hereditary taint — the physical defect 
of the parent being transmitted to the offspring. 
There are many instances where this would seem 
to be the case, where whole families seem to be 
afflicted with the same transmitted evil. But it 



THE TOOTH-BEUSH. 69 

will be found on close inquiry, in all such instances, 
that the individuals concerned have either been 
very particular in their attentions to these organs — 
knowing the evils under which their progenitors 
had suffered, and dreading its transmission — have 
sedulously applied the brush and the dentifrice, 
both of which, probably, like the fabled siren, 
"lured but to destroy;" or, being impressed with 
the belief that remedies were useless " where fate 
had set its seal," have neglected them entirely, 
and thus allowed the free action of every evil 
cause. 

There may be, and probably is, a slight difference 
in the constitution of the teeth of different indi- 
viduals ; also in the composition of the saliva from 
which the limy deposit, or tartar, comes ; in the 
form of the teeth, etc. All these may have a 
tendency to evil in particular cases ; but these, if 
facts and experience can be allowed to testify and 
determine, need only a more sedulous application of 
the proper remedies to obviate their evil tendencies. 
But this can not be accomplished by rasping the 
teeth and gums continually with a stiff, harsh brush, 
or the application of a corroding dentifrice. 



70 THE DENTIFRICE, 

THE DENTIFRICE, A CAUSE OF 
DENTAL DISEASE. 

The composition of compounds, professedly de- 
signed to beautify and preserve the teeth, demands 
particular consideration. The dentifrice is one of 
the humbugs of the age ; or, rather, many people 
are humbugged by them. Almost every dentist 
has his nostrum, by which he professes to accom- 
plish certain purposes. Many of them are at best 
harmless in their effects ; some are beneficial, and 
frequently very necessary ; but there are others 
which are imposed upon the community, which are 
decidedly injurious. They appear in the market 
in various forms — some in that of paste, some in 
powder, and others in a fluid form* Multitudes of 
teeth have been more or less injured, or entirely 
destroyed by them. These compounds frequently 
contain properties which act chemically upon the 
substance of the teeth. For the purpose of ren- 
dering them more white and beautiful, various 
acids are combined with other ingredients. Cream 
of tartar, or tartaric acid, the citric and oxalic 
acids, and others, are frequently used for this 



A CAUSE OF DISEASE. 71 

purpose. From neglect of the teeth, the enamel 
sometimes becomes very much discolored. This 
discoloration in some cases can not be removed 
without considerable trouble; and yet most per- 
sons, especially females, have a strong desire, 
where this is the case, to have this defect removed. 
Chemical compounds are therefore prepared and 
offered to the community under the guise of a 
dentifrice, with some high-sounding technicality 
attached, in order to invest its operation with 
magical obscurity, for the purpose of cleansing 
and beautifying and preserving these beautiful 
organs. 

Since the above was written, I have been shown 
an article of this sort offered very extensively for 
sale, a kind of preserving fluid. It proved, on 
examination, to be a weak solution of oxalic acid, 
put up in small bottles of two drachms each ; and, 
what is very remarkable, it found many ready 
purchasers, some of whom are persons of consider- 
able intelligence. 

To those at all acquainted with the chemical 
combinations of acids with other substances, the 
effects of such compounds will be perfectly plain. 



72 THE DENTIFRICE, 

The oxalic acid, when applied to the enamel of the 
teeth, combines with the limy portions of which it 
is in part composed, rendering them of a pearly 
whiteness. But this is only a temporary effect. 
Repeated applications, even of a very weak so- 
lution of these substances, will finally destroy the 
organization of the teeth ; and instead of the white 
and beautiful appearance which they first assume, 
they become permanently discolored, and at last 
crumble to pieces. This has been the fate of 
thousands, and all the result of cupidity imposing 
upon trusting ignorance. 

But there is another substance which has ob- 
tained a considerable degree of celebrity, and 
recently seems to be acquiring quite an extensive 
application as a dentifrice, against which the public 
needs to be warned, as it undoubtedly is the source 
of much mischief. I refer to the use of charcoal. 
The use of this substance as a dentifrice, and pre- 
servative of the teeth, was suggested by its known 
affinity for putrid substances, and its power to 
arrest putrefaction. Charcoal, applied to sub- 
stances undergoing putrefactive decomposition, will 
arrest this process for a time ; the idea was con- 



A CAUSE OF DISEASE. 73 

ceived, therefore, of making use of it to arrest 
the putrefactive process which has been described 
as taking place about the teeth of individuals, 
where perfect cleanliness is not constantly observed. 
If this substance is applied as a dentifrice in .-its 
recently prepared state, in a finely levigated and 
dry condition, it no doubt will subserve a highly 
beneficial purpose, provided it is thoroughly re- 
moved again from the mouth, or from about the 
teeth, after having parted with its antiseptic 
qualities. But, if it be applied to these organs, 
and allowed to remain between and about them for 
any considerable time, it loses its antiputrefactive 
powers, and serves only, by its affinity for putrid 
substances, to retain them in the position best 
calculated to develop and exert their deleterious 
energies. 

Many, perhaps most persons, who make use of 
a dentifrice for the preservation of their teeth, 
suppose that by bringing and retaining it in contact 
with them, it will therefore better effect its object. 
Indeed, I have known individuals who were in the 
habit of using charcoal in powder once or twice a 
week, being careful to abstain from the use of the 

4 



74 THE DENTIFRICE, ETC. 

brush, that the dentifrice might have the oppor- 
tunity to accomplish its purpose. In all such and 
similar cases, I have always found a swollen and 
livid appearance of the gums ; but where this sub- 
stance has been used with the free use of a proper 
brush — for there are a few such cases — -these or- 
gans have exhibited a more healthy appearance. 

It is therefore not the simple use of charcoal as 
a dentifrice, but the improper use or abuse of it, 
that is to be deprecated : for observation and ex- 
perience plainly show that this substance, used as 
it may be for the purpose above stated, becomes 
the instrument by w T hich to effect considerable good ; 
but used as it commonly is, it becomes the source 
of a great and increasing evil. For the last eight 
or ten years my attention has been directed par- 
ticularly to this subject; and from the observations 
I have been enabled to make, I am thoroughly 
convinced that the improper use of this substance 
as a dentifrice prematurely destroys multitudes of 
teeth annually. When charcoal is thus used, the 
gums put on a peculiar diseased appearance, an 
exhibition which is seldom seen except where this 
substance is used. It is far better, therefore, 



FILING INJURIOUS. 75 

never to use this article upon the dental organs at 
all, than to allow it to remain about them to serve 
as a nucleus to attract and retain the seeds of 
disease. 



FILING THE TEETH INJURIOUS. 

It is a remarkable fact, that the teeth, when, 
from any cause, whether natural or otherwise, are 
so placed in their sockets as not to be in contact 
with each other, having an interstice between what 
is commonly their contact surfaces, are not so 
liable to become diseased or carious, as where, as 
is generally the case, their juxtaposition places 
them in actual contact. This fact being matter 
of frequent observation, it probably suggested the 
operation of filing a space between these organs 
where nature had placed their opposing surfaces in 
contact. This was practiced very extensively by 
dentists a few years ago, and is by many, to some 
extent, at the present time. This operation is 
always more or less unpleasant, and sometimes 
very painful. But I refer now to filing teeth in a 
sound and healthy state, in order to prevent disease. 



76 FILING INJURIOUS. 

When they have become carious on their contact 
surfaces, it is necessary to separate them by filing 
in order to perform the operation of plugging ; but 
in this case the sensibility of the teeth is generally 
rendered so obtuse by the cause producing the disease, 
that but little or no pain is experienced in the oper- 
ation. Under such circumstances, therefore, it is 
admissible, for there is no other alternative. They 
can not be filled without it. But this necessity 
does not obtain where there is no disease. But 
many persons, desirous to preserve their front or 
incisor teeth, submit to have them separated in this 
manner by dental advisement, without having any 
definite idea of the effect generally produced. 

The manifest object to be obtained by this 
operation — for there can be no other — is to place 
the teeth asunder so as to prevent the lodgment 
between them of articles of food, and thereby 
prevent the action of corroding substances. Now, 
if this object could be obtained by the operation, 
and no other injurious effects be produced, there 
could be no objection to it; but, unhappily, this 
has seldom been the case. The effect generally 
produced by passing a file between sound teeth, is 



FILING INJURIOUS. 77 

to increase the opposing surface area, to induce an 
undue excitement, and, in many cases, an active 
inflammation in the teeth filed. The teeth are 
usually of such a form, that unless the filing is 
more extensive than what the irritation commonly 
produced will allow of, they will soon approximate 
to actual contact again. This is the case fre- 
quently when teeth are filed apart for the purpose 
of plugging. If especial care is not taken to file 
them in such a manner as to prevent the coming 
in contact of the increased surfaces, they are 
certain to decay again in a very short time. This 
is one reason why so many plugs fall out from de- 
cay of the teeth after filling. But sound teeth 
are so much more sensitive on being filed than 
carious ones — for caries usually obtunds the sensi- 
bility — that commonly it is very difficult so to file 
them as to prevent this result. The separation of 
the surfaces, therefore, is generally only temporary. 
When, therefore," after being .separated, they have 
approximated each other to contact, the same 
causes to which they were exposed previously now 
operate with increased energy. The filing having 
produced a more perfect coaptation of the opposing 



78 FILING INJURIOUS. 

surfaces, together with the irritation excited, decay 
is almost certain immediately to follow. Reason 
indicates this result ; experience confirms it. And 
yet dentists, for a few shillings, recommend and 
practice this operation, rather than honestly to say 
to those who consult them in regard to the best 
means to preserve the teeth — Nature has performed 
her office well ; do thine. It is an old adage, 
"Let well enough alone." When, therefore, the 
dental organs are free from disease, and in the 
condition in which Nature formed them, discretion, 
and prudence, and sound sense would seem to say, 
that the invention of man would not be very likely 
to improve upon this condition. Certainly the 
filing away a portion of the enamel, which evidently 
was intended to serve as a protection to the more 
sensitive bone beneath it, can in no wise render a 
tooth less liable to be destroyed by those causes 
which usually operate upon it. 

Having briefly referred to. the principal causes, 
and their modes of operation, which tend to en- 
gender disease of and destroy the dental organs, 
and endeavored to point out some of the evil results 
which arise from the improper use and the use of 



CLEANLINESS, AS A REMEDY. 79 

improper remedies, it now remains to state the 
true treatment which the various conditions and 
circumstances which involve these organs, both in 
health and disease, require, in order to protect or 
recover them from the common calamity to which, 
through ignorance, misapprehension, and cupidity, 
they are subject. 

CLEANLINESS, AS A REMEDY. 

It has been already stated, that certain structures 
which compose the physical organization imbibe dis- 
ease far less frequently than others. The osseous 
structure is one of these. The common causes 
which induce disease of other parts of the body, 
seldom affect the bones. Indeed, this structure is 
seldom the location of disease, except from acci- 
dental causes, or a general depraved habit. The 
teeth, being a portion of the bony structure, are 
therefore seldom attacked by diseases which de- 
pend upon general causes. A diseased tooth, aside 
from that produced by local causes acting upon 
that part of it covered with enamel, or from ex- 
cessive disease of the contiguous gum previously 



80 CLEANLINESS, AS A REMEDY. 

induced, is a very rare occurrence. The disease 
called caries, or gangrene, is entirely of a local 
nature, and is usually produced by local causes 
only. Generally, disease of the teeth does not 
depend at all upon the condition of other organs, 
aside from the gums. These organs may decay, 
and be entirely destroyed, and frequently are, 
while the other constituents of the organization 
remain in a state of unimpaired health — and vice 
versa. These facts are striking evidence of the 
local character of the causes which induce dental 
diseases. Hence it is, that, in the adaptation of 
remedies to the prevention or cure of dental diseases, 
those only which are local in their operation are 
found by experience to accomplish the end desired. 
All the dental remedies, such as brushing, scaling, 
filing, and plugging, are resorted to for the pur- 
pose of removing active local causes. 

It will no doubt be readily conceded, that the 
teeth come from the hand of Nature, ordinarily, 
endowed with the same degree of perfection as the 
other constituents which make up the human phys- 
ical organization. It will also be admitted, that 
if the various special agents which affect these 



CLEANLINESS, AS A REMEDY. 81 

organs can, by any means, be prevented from the 
exercise of their powers, they will remain subject 
only to the same general causes which influence the 
whole system, and that, therefore, they will con- 
tinue coextensive with other members of the body. 
Now if the causes which have been discussed in 
the foregoing pages are those only which usually act 
upon and destroy the teeth, and acting locally as they 
do — and it is believed that the subject has been made 
sufficiently plain — then it follows that the remedy 
which prevents or removes these effective causes 
will have accomplished the desirable object, the 
preservation of the teeth. Such a remedy will 
apply equally to the deciduous or temporary teeth, 
as to the secondary or permanent ones. When all 
the circumstances involving this subject, therefore, 
are taken into consideration, it becomes self-evident 
that perfect and constant cleanliness of the parts 
involved will effectually secure them against all 
the evils which commonly befall them. Provided, 
always, that the means adopted to secure this re- 
sult do not, like the brush which has been referred 
to, assist to establish what they are intended to 
cure. With the contiguous gums in a healthful 

4* 



82 CLEANLINESS, AS A EEMEDY. 

condition, the teeth, by the timely and continual 
application of means suited . to their thorough 
cleansing, can be as completely protected from 
disease as other organs. But the means used must 
be suitable, and properly and thoroughly adminis- 
tered. Let the mother, while engaged in the per- 
formance of her daily ablutions to her child, after 
the commencement of the first dentition, not forget 
to cleanse thoroughly from all impurities its teeth 
and gums ; let this be done with a soft, unirritating 
brush, and let that child be instructed, as its years 
accumulate, to use the instrument itself, and let it 
be required to make a thorough cleansing of these 
organs one of its daily duties, and this continued 
till puberty — let this become the general practice 
of mothers and nurses, then, seldom indeed will 
the necessity arise for those tedious and distressing 
pains and aches of the teeth and ear which so 
frequently afflict the period of childhood and youth, 
and in after life for incurring the expensive dental 
operations which are now so common ; and, above 
all, the loss of those organs designed to contribute 
so largely to man's health and comfort. 

Childhood and youth is the most important season 



CLEANLINESS, AS A REMEDY. 83 

for receiving instruction. It is especially so in 
regard to habits of cleanliness. The youth who 
has been trained to consider dental cleanliness as 
essential to his comfort and health of his teeth, 
will rarely neglect them in subsequent life. But 
this habit must be adopted early, in order to be 
effectual. Perfect immunity from the causes which 
have been referred to can only insure success. 
The prophylactic must therefore be administered 
previous to the first impressions of disease being 
made. The principle of action, however, is the 
same, whatever circumstances may predominate. 
If these organs have been neglected — if the gums 
have become diseased, the tartar deposit become 
considerable, and even numbers of the teeth more 
or less carious, still the practical principle has in 
view the accomplishment of the same object, the 
removal and prevention of the effective causes. 
Cleanliness, therefore, under all circumstances and 
conditions, is the great and important remedy. 
This remedy, thoroughly and constantly applied, 
after all dental operations, is absolutely essential 
to their success. Preparation of the teeth and 
gums, or, rather, a condition of them, is necessary, 



84 CLEANLINESS, AS A REMEDY. 

which, if cleanliness is observed, places them be- 
yond the reach of the destructive agents, and 
which can only render any other means efficient 
to preserve them. That condition must be a 
convalescent one, at least so far as disease of the 
parts contiguous to the teeth are concerned. To 
place them in such a state, cleanliness must always 
be strictly observed, auxiliary to which a properly 
constituted dentifrice becomes an important ad- 
junct. 

The first great object, then, to be obtained, what- 
ever the circumstances of the case may be, is, to re- 
move and prevent the further operation of the efficient 
cause, by cleanliness. If the teeth and gums have 
become irritable and inflamed by the calcarious de- 
posit, this is to be removed by suitable instruments, 
and the diseased gums restored by appropriate 
applications, which will be referred to hereafter. 
If the teeth have become carious, they, too, are to 
be treated as their condition demands. To these, 
also, I shall refer again. The first and most im- 
portant object, however, to be attained in the 
dental treatment, is cleanliness. 



THE TOOTH-BRUSH, ETC. 85 

THE TOOTH-BRUSH, A MEANS 
TO OBTAIN IT. 

To remove all impurities from about the teeth 
and gums being the first in order of dental treat- 
ment, the means by which it can best be accom- 
plished demands attention. It is of very little 
importance what instrumentalities are adopted, only 
so they are efficient. The use of the tooth-brush 
for this purpose, so far as any means are used, has 
become almost universal ; and there probably can 
not be, at all events there never has been, an in- 
strument superior to it in all respects. But it 
must be properly constructed, and of suitable ma- 
terial. It should be what may be termed a soft 
stiff brush. It should be soft and unirritating to 
the gums, and at the same time sufficiently stiff to 
enable one to cleanse thoroughly his teeth by ob- 
taining access to every recess. Such instruments 
are manufactured, and may be obtained ; but they 
are rarely found in the markets, owing to the fact 
that a cheaper article usually has the most ready 
sale. But of the common brush, and its pernicious 
qualities, sufficient has already been stated. 



86 THE DENTIFRICE, 

The use of plegets of cotton, or floss silk, is 
sometimes resorted to for the purpose of more per- 
fectly cleansing the teeth. This practice is a 
beneficial one ; but the brush, if properly con- 
stituted, and assiduously and perseveringly applied, 
will meet the necessities of every case. But care 
should always be taken not to irritate the gums, 
whatever remedies may be resorted to ; and it is 
better for the welfare of the teeth that they be 
entirely left to all natural influences, than to be 
subjected to the harsh applications so frequently 
made use of. 



THE DENTIFRICE, AS A REMEDY. 

I have already referred to various compounds 
used upon the teeth as sources of evil. As a 
remedy, however, the dentifrice, when properly 
constituted, is of great importance, and may render 
essential service in the treatment of dental diseases. 

In the preparation of a remedy of this nature, 
its design is the first object of consideration; and 
the second is, what combination of ingredients will 
best accomplish the end in view. 



AS A EEMEDY. 87 

The gums, it will be remembered, are affected 
by the same agents which corrode and destroy the 
teeth. In most cases, therefore, where these causes 
are allowed to exert their influence, the gums be- 
come more or less excited in an undue degree. 
They frequently become spongy and swollen, and 
when the excitement is intense and long continued, 
scorbutic. To overcome this diseased condition, 
medicine may be of essential importance, and is 
sometimes very necessary. To restore and pre- 
serve the gums in a healthful condition, therefore, 
is the first object to be attained by remedies of 
this kind. 

There are various compounds prepared by den- 
tists and others, and sold in the markets, which 
propose to prevent as well as remedy the diseased 
conditions to which the teeth and gums are subject. 

Some of the nostrums which are vended for this 
purpose, are prepared with a view to the immediate 
effect which they produce on application. These 
contain properties which act chemically, and, al- 
though they may render the teeth of a pure white 
for a time, in the event serve only to destroy them. 
As the ordinary condition of the teeth and gums, 



88 THE DENTIFRICE 



however, particularly the latter, require the fre- 
quent application of a proper dentifrice, it is of 
importance that the virtues of these preparations, 
and their mode of operation, should be well under- 
stood. 

As I have already stated, to remedy diseases to 
which all are liable, the world have gone in pursuit 
of specifics. It is particularly so in relation to 
remedies for preserving the teeth. Without any 
idea of the specific effect to be produced, having 
but a general apprehension that virtue is wrapped 
up in the mysterious preparation, individuals pur- 
chase nostrums of this sort, and apply them, with- 
out even knowing their reputation for good or evil. 
When injurious results follow their application, 
they are commonly attributed to any other cause 
than the true one. People generally are not willing 
to believe, that a nostrum obtained as an expensive 
remedy, promising miraculous benefits, is but a 
mere deception, or destroying evil. But where 
experience produces unmistakable evidence of the 
injury it has accomplished, the whole list of remedies 
are usually condemned, and equally denounced. 
Hence, the only safe course in regard to nostrums 



AS A REMEDY. 89 

of this kind, is to reject them altogether, where 
their virtues are not authenticated . 

As a general rule, very little benefit may be an- 
ticipated from any remedy of this sort, while the 
teeth are incrusted with tartar, and general clean- 
liness of them and the gums is neglected. There 
are also certain conditions of these organs, for 
which no general remedy, applicable to all other 
cases, can be w T ith propriety prescribed. There 
are cases in which a strong solution of lunar 
caustic is indicated, and others where other specific 
and potent remedies are required. Of these it is 
not my design to speak. They require the imme- 
diate attention of the physician or surgeon. But 
there is a condition of these organs which presents 
a general sameness in all cases, and to which 
remedies of the same class, having a similar spe- 
cific operation, will generally apply. This is the 
ordinary condition which usually presents to the 
dentist's notice. 

The diseased condition of the gums referred to 
is not induced suddenly, nor by causes which pro- 
duce violent effects, but is established gradually, 
as the force of the causes increases. The diseased 



— — 



90 THE DENTIFRICE, 

condition of the gums, therefore, is what is termed 
chronic. This is especially true of the cases of 
adult persons as they commonly come under the 
notice of the dentist. When once established, this 
condition will continue so long as there is tartar 
upon the teeth, or the product of putrefaction is 
allowed to exert its influence. As a means, there- 
fore, to assist in the preservation or restoration of 
health of diseased gums, the legitimate operation 
of a properly constituted dentifrice is, to neutralize 
the product of putrefaction, to prevent the accu- 
mulation of tartar, and stimulate the vascular 
substance of the gums to a changed and healthy 
action. 

In the selection of medicinal substances for the 
composition of such a compound, reference should 
be had to the specific effect necessary to be pro- 
duced. As there is commonly a want of energy, 
a lax condition of the gum, the remedy should 
be such as to impart strength, and give tone to its 
fibre. If the product of putrefaction be an acid, 
then an alkali becomes necessary to neutralize its 
deleterious qualities. But theory, in order to be 
a safe and efficient guide, must harmonize with 



AS A REMEDY. 91 

practical demonstration. Experience is not to be 
discarded in practical medicine. Among the arti- 
cles of the materia medica, there are those which, 
from their known peculiar qualities, are used for 
specific purposes. For example — opium, by ex- 
perience, is known to possess what are termed 
narcotic properties. It allays nervous excitement, 
subdues pain, and induces sleep. The indications 
of a diseased body, therefore, determine the ne- 
cessity for its application. Peruvian bark imparts 
a tonic power; nutgalls, or alum, applied to the 
muscular fibre, produce an astringent effect, which 
also gives tone to the vital energy. Some sub- 
stances combine several distinct qualities within 
themselves, although, may be, in less degree. 

It is ascertained by observation, that certain 
active properties, when existing in combination 
with others, as exhibited in certain articles of 
medicine, have a more beneficial effect upon par- 
ticular structures of the body than when they are 
applied under other circumstances, or when ex- 
hibited alone, or in other combinations. Thus it 
is that certain compounds, containing a variety of 
particular medicinal properties, have obtained a 



92 



reputation for virtues imparted in particular cases. 
For instance — compounds into which myrrh enters 
as an ingredient, have become justly celebrated in 
many local diseases where astringent and tonic 
properties were indicated. Hence the extensive 
employment of this drug as a dentifrice, for ex- 
perience demonstrates its utility in the ordinary 
diseases of the gums. But a dentifrice should 
contain other powers than those possessed by 
myrrh alone. To meet fully the indications of 
the dental organs as presented under all circum- 
stances, except in extreme cases of disease, a 
dentifrice should combine gently stimulant and 
astringent tonic powers, together with antacid 
properties, or such principles as will neutralize the 
corroding agents resulting from putrefaction, and 
render them harmless. A compound combining all 
these qualities, operating in harmony with each 
other, for general use, has long been a desidera- 
tum. 

For the last twelve years this subject has occu- 
pied a considerable portion of my time and at- 
tention. With a view to the preparation of a 
dentifrice answering these ends, I have made 



AS A REMEDY. 



93 



various experiments in the combination of sub- 
stances, observing closely their practical effects. 

The Compound Tooth-paste, a recipe for the 
preparation of which is appended to this work, is 
the result of those years of labor. I believe it to 
comprise all that can be anticipated from remedies 
of this nature. I have prescribed it for the last 
eight years as a dentifrice, and have had the satis- 
faction to witness its beneficial effects in numerous 
instances, as well as the gradual extension of its use 
beyond the limits of an extensive dental practice. 
Those who have once used a box of it are never 
after willing to be deprived of its benefits. When 
care is taken in its preparation, and selecting the 
ingredients of which it is composed, it is a very 
pleasant, mild, safe, and agreeable dentifrice. It 
must not be forgotten, however, that a properly 
constituted tooth-brush is a necessary prerequisite 
to its application, and development of its peculiar 
virtues. 

I have also appended other recipes for com- 
pounds, which have been very serviceable in par- 
ticular cases. The one numbered 7 has been found 
very beneficial when applied in cases where the 







'W 







9i SCALING THE TEETH. 

teeth have become loosened, and gums spongy and 
irritable from mercurial influences. 

That numbered 8 is a very elegant wash for the 
teeth and gums. A few drops in half a wine-glass 
of water makes a very agreeable wash for the 
mouth for common use. 

In reference to the remedial powers of agents 
of this sort, it is no more than truth to say, that 
generally individuals anticipate too much. A com- 
pound, the constituent elements of which are not 
known to the public, is invested with extraordinary 
virtues by the imagination, simply because its 
composition is shrouded in mysterious secrecy. 
It is so in all departments of practical medicine. 
Individuals, therefore, should not trust too much 
to remedies of this kind, but only employ them as 
auxiliary to those of more importance, which have 
been referred to. 



SCALING THE TEETH. 

The calcareous substance, or tartar, held in 
solution by the saliva, when deposited upon the 
teeth, and suffered to accumulate, becomes a serious 



SCALING THE TEETH. 95 

evil. Its evil effects have already been briefly- 
adverted to. Its remedy remains to be stated. 
It will be remembered that this deposit is very 
seldom noticed during the period of childhood. It 
appears earlier in some cases than in others, but 
is rarely seen in any considerable degree until the 
period of advanced adolescence. This substance, 
when first deposited upon the teeth, is of a soft 
and cheese-like consistence. It is therefore very 
readily removed by the use of the tooth-brush 
already described. And it may be observed here, 
that one of the essential virtues of a properly 
constituted brush is, that this deposit of tartar can 
be reached by it in all the interstices into which it 
may insinuate itself. 

If, then, the means which have been described as 
important to the preservation of the dental organs 
were applied as they always should be, there would 
never arise the necessity for thq adoption of any 
others for the purpose of remedying this evil. But 
the accumulation and induration of tartar upon the 
teeth of adults is almost universal. Rarely, in- 
deed, does the practical dentist meet with an indi- 
vidual who does not require the assistance of other 



96 SCALING THE TEETH. 

means than those merely prophylactic, to correct 
the evil arising from this substance. 

When the tartar has been allowed to accumulate 
and harden upon the teeth, the tooth-brush, what- 
ever its qualities may be, is entirely inefficient to 
remove ito There is no chemical agent sufficiently 
energetic for its removal without endangering the 
teeth themselves. Hence it becomes necessary to 
resort to the use of instruments of steel or other 
hard metal for the purpose. The removal of tartar 
from the teeth in this manner is usually denominated 
scaling them. 

Scaling instruments, formed and adapted to this 
particular purpose, are therefore always a compo- 
nent part of a dentist's case. The tartar usually 
insinuates itself between the teeth and the free 
edge of the gum. In order to remove it, therefore, 
the instrument has to be passed below it and drawn 
up. If the instrument is sufficiently sharp, there 
is commonly no difficulty in scaling it off, which 
sometimes occurs in large masses. Care should 
always be taken when this operation is performed, 
that none be left to serve as nuclei for its re- 
formation, whieh is very likely to happen where 



SCALING THE TEETH. 97 

this is the case, whatever means may be adopted 
to prevent its reaccumulation. Many persons 
entertain a prejudice against this operation. They 
suppose that by scraping the teeth with a sharp 
instrument in order to remove the tartar, that the 
teeth themselves receive more or less injury. To 
the practical dentist the reason for this prejudice 
will at once appear obvious. Individuals neglect 
all the means by which the various causes may be 
prevented from injuriously affecting their teeth, 
they become incrusted with tartar, the gums be- 
come more or less swollen and spongy — at least 
diseased to some extent — and the teeth themselves, 
although perhaps unknown to them, being obscured 
by the tartar and condition of the gums, are be- 
come carious. In this condition application is 
made to the dentist. He proceeds to apply the 
remedy. The operation of scaling is performed. 
With many dentists nothing further is prescribed, 
there being no other mechanical operation neces- 
sary. Under the impression that removing the 
tartar is all that is required, 'the same condition 
continues which previously existed, with this 
difference — the teeth are more exposed and easily 



98 SCALING THE TEETH. 

examined, and thus the fact is made manifest that 
they are decaying, the immediate cause of which is 
attributed to the scraping they have received. 
The judicious and conscientious dentist will therefore 
always decline the performance of this operation, 
except he has good reason to believe that his patient 
will adopt the recuperative means necessary to 
render this operation beneficial to him. 

Although this operation is a very important and 
necessary one, and one which requires no very 
great skill on the part of the dentist, yet there is 
frequently great fault in its performance. In cases 
where tartar has been suffered to accumulate to 
much extent, especially if the gums are much dis- 
eased and bleed, it is not a very agreeable task on 
the part of the operator ; and sometimes, to fulfill 
what the circumstances of the case demand, re- 
quires a self-sacrificing spirit, even more than 
commonly falls to the lot of men engaged in this 
pursuit. Hence it is that this manner of removing 
the tartar from the teeth is so frequently inef- 
ficiently performed. 

But this substance may be removed by the in- 
dividual himself on whose teeth it accumulates. 



th an instrument suitably can 

remove small pa: which mi r iily be 

found I When the teeth are perfi 

from 

arp it may be, will pass smootl 
them. P may be assured, ther ■:-: . 

a it catches, or when a 

upon which : 
meL: \g indurated tartar upon if 

te particular point. It 
sometii- .uires 

::. The : the more e: 

and in be 

A sited and 

- upon tt 
common c t means above referred to are 

an immediate 
source of irritation : 

posed to pay all d these organs 

should be provided with scaling 

purpose of : r himself. 1 

purchase 
ments of this i ppliod whe: ^casion 

lered it neeesr an in- 



100 SCALING THE TEETH. 

dividual of what he would otherwise pay to the 
dentist, and, above all, prolong the existence and 
usefulness of these, while the necessities of other 
organs require their assistance. 

Since the commencement of this article on 
scaling the teeth, I have been called to examine 
the mouth of a lady some fifty-five or sixty years 
of age for the purpose of inserting a set of arti- 
ficial teeth, who has but four teeth remaining, one 
in the upper and three in the lower jaw. The 
others had fallen out within the last two years, all 
of which were exhibited on the occasion. No dis- 
ease nor blemish was to be observed on any one of 
them, except that they were all more or less in- 
crusted with the tartar deposit. They seemed to 
have been perfectly protected from the effect of 
other deleterious influences by this indurated 
deposit; but which, with other agents, had so 
excited the gums and the bony sockets of the 
teeth to diseased action, that they had been 
entirely removed by the process of absorption. 
The teeth, therefore, having been deprived of their 
support, had fallen out, while in other respects 
perfectly sound. Had this individual timely re- 



SCALING THE TEETH. 101 

sorted to the scaling operation, and had the teeth 
entirely freed from tartar, subsequent cleanliness 
no doubt would have been all-sufficient to have 
made the duration of these organs commensurate 
with the other constituent members of the body. 

This is not an isolated case. They are of very 
frequent occurrence, although commonly the teeth 
become more or less carious previous to falling out. 

It becomes those individuals, therefore, whose teeth 
have this indurated calcareous deposit upon them, 
and are becoming loosened from inflammation and 
sponginess of the gums, and consequent absorption 
of their osseous support, to see to it that this con- 
dition be remedied by the means which have been 
pointed out; or else, as in the case of the lady 
referred to, they may reasonably expect that the 
fate of their teeth will be similar to hers. But 
let no one flatter himself that this condition can be 
remedied by the simple application of any mys- 
terious compound or pretending nostrum, although 
its name be far fetched, and there be claimed for 
it the power of magic. * 



102 PLUGGING TEETH. 



PLUGGING OR FILLING CARIOUS 
TEETH. 

When the prophylactic means which have been 
pointed out as necessary for the preservation of 
the teeth have been neglected, and they become 
carious, other remedies than those already con- 
sidered become necessary. To remove the causes 
which have induced disease and decay of the teeth, 
and subdue the irritation of the parts contiguous 
to them, is not sufficient when caries or mortifi- 
cation of their substance has commenced. It may, 
perhaps, answer, so far as the organs are concerned 
which are not immediately affected ; but the affected 
ones require another remedy. This is called plug- 
ing. It consists in the removal of the decayed or 
mortified matter of the diseased tooth, and stopping 
the cavity from which it is taken with a substance 
at once indestructible and not liable to chemical 
change. 

TMfe is an important operation. It is an ex- 
pensive remedy, as the most costly material is 
generally made use of for the purpose. It also 



PLUGGING TEETH. 103 

acquires a degree of interest from the fact that, if 
it fails to arrest the progress of disease, all hope 
of prolonging the usefulness of the affected member 
fails with it. It is the last remedy, so far as the 
natural organs are concerned. 

This branch of the dental art is practiced with 
various degrees of success. There are many who 
avail themselves of it, and who suppose they have 
thoroughly tested its remedial benefits by their 
own experience ; nevertheless conclude that but 
little or no reliance can be placed upon its healing 
virtues. They view the operation of plugging the 
teeth as an experiment of very uncertain tendency. 
Others, again, have full faith and confidence in its 
preserving power ; and they, too, appeal to ex- 
perience as the basis upon which their opinions 
rest. These diverse opinions will probably con- 
tinue to exist so long as the general principles 
which control the operation for good or for evil, of 
all dental remedies, are so little understood, and 
their practical application neglected. 

There are a variety of circumstances involving 
this subject which are necessary to be considered, 
in order to estimate correctly the value of this 



104 PLUGGING TEETH. 

operation. To calculate its success, the observ- 
ance of three prominent particulars is necessary. 

The first particular to be considered is, the con- 
dition of the organs to be filled, and the parts in 
close proximity to them ; the second is the manner 
in which the operation is performed ; and, thirdly, 
the treatment which the dental organs receive after 
the plugging operation is accomplished. 

In regard to the first proposition, it has already 
been stated that the health of the teeth depended 
upon the removal of the destructive causes, which 
have also been pointed out. This is necessary 
in cases where caries has not yet commenced. 
When mortification of the teeth has taken place, 
however, it is still more necessary, if possible, 
that means should be adopted to remove all dele- 
terious agents, and restore the organs to their 
naturally healthy condition. The removal of the 
decayed substance of a tooth, and filling the cavity 
from which it is taken, is one means by which this 
^condition is established. But this operation can 
not be effective without the previous use of means, 
when such means are required. Very little benefit 
can be expected from the operation of plugging the 



PLUGGING TEETH. 105 

teeth while the gums are diseased and sensitive, or 
they themselves are irritable. Here is one of the 
main reasons, the secret of success in the practice 
of certain dental operators. The mechanical skill 
and practical experience will avail but very little, 
if due attention is not paid to the general condition 
of the organs operated upon. Hence those dentists 
who merit and obtain a reputation for professional 
skill, especially in this particular branch of it, are 
always particular to note the existing condition of 
all the parts involved, and adopt such means as 
the case demands. This is one of the main ob- 
jections to the employment of the itinerant dentist. 
It sometimes consumes considerable time in the 
proper preparation of the organs previous to filling, 
and this preparation may be absolutely essential to 
success in the particular case, and yet time, so far 
as the dentist is concerned, will not allow of this, 
and consequently the teeth are filled without it. 
The final result is, the plugging is not successful, 
the disease continues, the plugs fall out, and the 
teeth are lost. 

Many dentists, and especially that ciass to whom 
I have referred, the itinerant portion, practice upon 

5* 



106 PLUGGING TEETH. 

the principle that " a bird in the hand is worth 
two in the bush;" and therefore they invariably 
advise the filling of every tooth which is susceptible 
of being plugged, without regard to the circum- 
stances which involve it. The prospect of a few 
ready shillings is sufficient to bias the better judg- 
ment, and set aside all conscientious scruples. 
This may be thought rather severe upon the pro- 
fession, but the result of the practice of quite a 
large portion of its members authorizes the as- 
sertion. 

The condition of a carious tooth, then, in order 
that it may be filled with a fair prospect of re- 
moving the disease, must be freedom from general 
irritation of its own structure, and that of other 
organs in close proximity to it. Unless this con- 
dition does exist in fact, or a convalescent state 
tending to it, any increase of excitement — which 
the operation of plugging always produces in a 
greater or less degree — will, instead of being a bene- 
fit, only serve to hasten its destruction. Indeed, 
such is frequently the result of premature filling 
carious teeth, and hence the want of confidence in 
the dental profession which so extensively prevails. 



PLUGGING TEETH. 107 

The second proposition, the manner of filling 
carious teeth, is a matter of much general interest. 

When the general condition of the teeth and 
gums has received the attention demanded in a 
given case when a tooth has become carious, the 
operation of removing the diseased matter, and 
filling the cavity from which it is taken, is to be 
accomplished as the next step in the remedial 
course. The rationale of this operation is simply 
this : The efficient cause of the caries being of a 
local character, the disease consequently is more or 
less circumscribed in its action. If, therefore, the 
diseased portion of a tooth can be perfectly re- 
moved, leavingno traces of inflammation to operate 
upon its vitality, and if the surface of its cavity 
thus produced is made perfectly dry and free 
from the deleterious agents which induce caries, 
and if in this condition the cavity be perfectly 
filled, and with a material which shall effectually 
prevent all further contact of such agents with 
the cavity, the subsequent treatment being properly 
attended to, the disease may be arrested, and with 
perfect assurance pronounced cured. 

The cavities produced by the removal of carious 



108 PLUGGING TEETH. 

matter are of all variety of forms, the surfaces of 
which are very irregular. The material, therefore, 
used for stopping, should be of such a nature as to 
be easily moulded to their unevenness, and ren- 
dered so compact as to exclude all fluid, as well as 
solid substances. The cavity should be perfectly 
filled, and the stopping polished down even with its 
margin, so as to leave no projecting points for the 
lodgment of offensive particles. When a tooth 
has become so extensively decayed, or the carious 
portion of such a form, or in such a place, that 
these conditions can not be fufilled, there is very 
little reliance to be placed upon the plugging 
operation. 

This particular branch of dental surgery, as I 
have already stated, is of more importance than 
any other. The dental operator more frequently 
fails in this than any other part he has to 
perform. Unless he is actuated by some higher 
motive than that of gain, he is very apt to slight 
his work ; and although he may be qualified in 
every other respect for the practice of his pro- 
fession, if he lack integrity the fact will manifest 
itself in this department of his practice, if in no 



PLUGGING TEETH. 109 

other. There are a variety of ways in which this 
may be done. Some have a practice of rolling up 
some base metal, as tin, in a covering of gold foil, 
or inserting the base metal at the bottom of the 
cavity and capping it over with gold. In these 
cases, of course, a golden price is always charged. 
A tooth may be filled with less than one half the 
amount of material necessary to the accomplish- 
ment of the operation as it should be, and yet the 
wrong can not be detected by any ocular exam- 
ination, and one, or even two years may elapse be- 
fore the fraud manifests itself, and then not to the 
understanding of the individual subjected to the 
imposition. The cause of the failure is more fre- 
quently attributed to the inefficiency of the art 
itself than the true source, the deception of the 
dentist. 

When the teeth are filled under the circum- 
stances which have been described as necessary to 
success, it remains only for the individual possess- 
ing them to exercise a due degree of care to pre- 
serve them from the further encroachments of 
disease ; and this is the third proposition. The 
means necessary to be adopted for the preservation 



110 DESTRUCTION OF THE NERVE. 

of these organs after plugging, have already been 
described. They are the ordinary measures of 
cleanliness, etc., and need not be repeated. But 
many persons suppose that, having obtained the 
assistance of the profession which the circum- 
stances indicate as immediately necessary, nothing 
further is required. In this there is a great 
mistake. If cleanliness is ever necessary for 
the health and preservation of the teeth and 
gums, it is especially so after having them sub- 
jected to the process of plugging. Left to the 
influence of causes which have first induced dis- 
ease, this condition will very soon again supervene. 



DESTRUCTION OF THE NERVE IN 
ORDER TO PLUG TEETH. 

What has been stated above has reference to 
teeth which are comparatively but little decayed. 
When they become so much diseased that caries 
penetrates the internal cavity and exposes the 
nervous pulp, to avoid the pain which is liable to 
supervene, it usually becomes necessary either to 
extract the diseased organ, or adopt some method 



DESTRUCTION OF THE NERVE. Ill 



by which its cavity can be filled and its usefulness 
prolonged. Most persons have a great dread of 
having teeth extracted. Any other remedy which 
the dentist may propose will be entertained before 
this. And yet, as a general rule, where a tooth 
has become so diseased as to be painful from ex- 
posure of its nerve, much suffering and trouble 
will be spared the individual by having it promptly 



c 





SECTIONS OF TEETH, EXHIBITING THEIR STRUCTURE 
AND DISEASE 

A represents an incisor, divided through its centre; a, the bony part; b, 
the enamel ; the dark central line, c ; the cavity of the nerve, which passes 
in at the extremity, d. B shows the lessening of the cavity as age advances, 
which in youth and early manhood has the form of C; C also represents 
caries penetrating the nervous cavity ; D exhibits a diseased tooth become 
ulcerous. 

and at once extracted. Owing, how T ever, to the 
repugnance which is commonly manifested to this 
operation, the dental profession have endeavored 
to devise some means in order to save its necessity. 



112 DESTRUCTION OF THE NERVE. 

Destruction of the nervous pulp — the only sensi- 
tive portion of a tooth in a state of health — is the 
most common method attempted to effect this 
purpose. This is accomplished by exposing the 
nervous pulp by removing the dead matter, and 
applying some escharotic substance directly upon 
it, and thus by a chemical process destroying its 
vitality. When this is effected, the tooth can be 
filled without pain. This practice is adopted very 
extensively by some practitioners. But this oper- 
ation can only be viewed as an experiment of very 
uncertain tendency. In a great majority of cases, 
notwithstanding all the care which may be used, 
inflammation of the investing membrane of the 
tooth will take place, and induce ulceration — for 
which there is but one remedy, and that is ex- 
traction of the diseased member. Many persons 
labor under a misapprehension in regard to the 
benefits to be derived from this practice. They 
suppose that, as pain is the result of nervous in- 
jury, therefore when the nerve of a tooth is by any 
means destroyed, or rendered permanently insen- 
sible, all pain will necessarily be removed, and 
without the danger of its recurrence. And this 



DESTRUCTION OF THE NERVE. 113 

idea is held out to the public by many practitioners. 
But this is mere pretension. So far as the tooth 
itself which is affected is concerned, this may be 
true ; for when the nerve of the tooth is destroyed, 
its vitality is also destroyed, and where there is no 
vitality there can be no sensibility. But it will be 
remembered that the teeth are set in bony sockets, 
lined with vascular membranes, possessed of vi- 
tality, and endowed with nervous sensibility ; and 
when this membrane becomes inflamed, it also be- 
comes extremely sensitive. A tooth, therefore, 
deprived of its nerve and blood-vessels, and conse- 
quently of its vitality, becomes as any other ex- 
traneous or foreign substance, with this exception — 
it is perfectly fitted to the place it occupies. Some- 
times a tooth in this condition may remain for 
years without exciting any appreciable amount of 
irritation ; but in a large majority of cases irri- 
tation and ulceration are the result of such a 
condition. There are cases recorded of foreign 
substances, as a leaden bullet for instance, having 
penetrated different structures of the body, be- 
coming imbedded in them, the organized parts 
healing around them. In this condition, years 



114: DESTRUCTION OF THE NERVE. 

have passed without any particular manifestation 
of excitement from the extraneous substance ; but 
on the accession of any new exciting cause, in- 
flammation and its consequences are always liable 
to supervene. Precisely so with a tooth deprived 
of its vitality or life by the destruction of its nerve 
and blood-vessels. In its natural position, it be- 
comes like the imbedded bullet. The cavity pro- 
duced by the disease, through which the nerve has 
been exposed and destroyed, may be filled so as to 
arrest the process of decay, and, like the bullet, the 
tooth may remain in this condition for years, with- 
out producing any manifest disturbance ; and yet 
a little exposure, a cold, any interruption of the 
general health, may at any time excite inflammation 
and all its train of unpleasant results in its bony 
socket. This, as I have already stated, is the 
result in a large majority of cases. Such, indeed, 
is the uncertainty of this operation, that no dentist 
who values his reputation will venture any abso- 
lute assurance of its success, in any given case; 
and yet the public are greeted from almost every 
newspaper in the country, by the flaming pre- 
tensions of members of the profession, claiming to 



DESTRUCTION OF THE NERYE, 115 

save teeth by this process, and restore their use- 
fulness, and prevent the painful consequences which 
otherwise would occur. And it must be admitted 
that the public, to a great extent, are deluded into 
the adoption of this pernicious practice of filling 
diseased teeth irrespective of circumstances. 

As I have before stated, most persons are willing 
to adopt almost any method to avoid the necessity 
for having their teeth extracted. Dentists are 
well aware of this, and it is to be regretted that so 
many of them are disposed to pander to this 
general predilection. In many cases health is 
sacrificed, a long train of nervous affections is in- 
duced, and years of suffering endured, which, had 
the surgeon dentist advised in accordance with 
his better judgment, would have been entirely 
avoided. 

It is remarkable that teeth which are very much 
diseased, the nerves of which are destroyed, and 
their cavities filled, are far less liable to the com- 
mon form of toothache than when not filled. 
They may be diseased to such an extent as to pro- 
duce constant ill health of the individual, and yet 
no particular local pain manifest itself, sufficient 



116 DESTRUCTION OF THE NEEVE. 

to convince him that these organs are the source of 
the difficulty. Those individuals who have had 
several teeth of this description filled with the ce- 
ment or amalgam so extensively used, are especially 
liable to neuralgic affections. This no doubt is one 
of the main reasons why nervous diseases are so 
much more prevalent now than formerly. Teeth 
become carious, the disease is allowed to progress 
until their nerves become affected, and, may be, 
destroyed ; and in this condition application is 
made to the dentist. Many members of the dental 
profession seem to think it detracting from their 
dignity, at least from their ability as dental prac- 
titioners, to acknowledge the necessity for losing 
a tooth which has any substance left, sufficient to 
be pasted up. Notwithstanding all experience 
would indicate the better course as generally that 
of extraction at once, plugging is more often resorted 
to. And many there are, who, although they may 
remain ignorant, and willingly so, of the real source 
of the ill health which they experience, still have 
abundant reason to regret ever having submitted to 
this, under other circumstances, important remedial 
operation. But recently, a lady called upon me to 



DESTRUCTION OF THE NERVE. 117 

obtain professional advice, whose case is a fair 
representation of numerous others, which are daily 
occurring. 

Some four or five years since, this lady, then 
residing in a western city, having suffered consider- 
ably from disease of the teeth, applied to a prominent 
dentist for relief. Nearly all her molar or grinding 
teeth were more or less decayed, and some of them 
very much so. The recommendations of the dentist 
accorded with her own wishes, and they were all 
filled with metallic paste. They had never given 
much trouble, except when articles of food accident- 
ally found access to the sensitive part exposed by 
the disease, and any pain thus produced had always 
been relieved by removing the offending agent. But 
from the time they were filled, all difficulty of this 
sort ceased. 

After an interval of several months, as the cir- 
cumstances were related to me, she began to feel 
occasional transient pains, some of which were very 
acute and lancinating — about the face, neck, and 
head, although there was no local or fixed pain. 
Neither had these wandering pains any particular 
reference to any one of the teeth. At first, but 



118 DESTRUCTION OF THE NERVE. 

very little inconvenience was felt, but, as time 
passed, symptoms similar to those mentioned 
gradually increased in frequency and intensity, 
until the general health, which formerly had been 
good, began to decline, and a state of general 
nervous excitement, or neuralgia, pervaded the 
system. At times, this general nervousness would 
become very intense, causing constant restlessness 
and wakefulness, at others less so, depending ap- 
parently upon atmospheric vicissitudes. Finally, 
these difficulties gradually increased in intensity, 
until they assumed the character of a formidable, 
and afflicting disease. During all this time, the 
teeth had remained comparatively quiet, and not 
even a suspicion being excited against them as^the 
origin of the trouble. Various remelies were 
resorted to, but with little or at most a temporary 
benefit. At length, however, the attending phy- 
sician, having exhausted his stock of nervine 
remedies, and still finding his patient declining, 
very sagely came to the conclusion, that if the teeth 
did not produce the difficulty, he could not divine 
its cause, although he had previously given a con- 
trary opinion. 



DESTRUCTION OF THE NERVE. 119 

Under these circumstances. I was consulted. 
On examination of the mouth, I found seven molar 
teeth filled with an amalgam or metallic paste. Most 
of them, previous to being filled, were decayed, so 
that at least one-half the crown of the tooth was 
gone. All of them were decayed very much. But 
having been faithfully attended since being plugged, 
they had been perfectly preserved from further 
decay. They had evidently been filled by a skillful 
and practiced hand, and assiduously cared for since 
this operation. To the cursory observer there were 
no indications of disease about these organs, more 
than those presented at the time of their beJng 
filled. There was but very little apparent excite- 
ment about the gums, no unusual tenderness of the 
teeth, and no pain produced by pressure on them. 
Even the lady herself was not willing to believe that 
her sufferings were occasioned by her teeth, although 
she had noticed that certain acute erratic pains, 
seemed to originate in the neighborhood of a par- 
ticular tooth, which was filled in the manner referred 
to. But her sufferings had become so intense and 
constant, that she was willing to submit to the 
operation of having her teeth extracted, if perchance 



120 DESTRUCTION OF THE NERVE. 

there was but a probability that by so doing she 
could obtain relief. 

Having become acquainted with all the circum- 
stances of the case, I unhesitatingly gave it as my 
opinion, that the whole difficulty arose from dental 
disease, and therefore advised the immediate ex- 
traction of all the seven teeth to which I have 
already adverted. I therefore proceeded to remove 
them. At the first sitting I removed three, which 
had the effect to change very much the character of 
the neuralgic affection, and lessen its intensity to 
some extent for a time. But it soon reacquired its 
former severity, and in about two weeks from the 
time of extracting the first three, I removed the 
other four. From that time to the present, which 
has been some months, no symptoms of nervous 
disorder have manifested themselves, and the general 
health has become entirely restored to its former 
state previous to the teeth becoming diseased. 

This case, I repeat, is but a single instance, but 
it represents, in some degree, the thousands which 
are annually occurring in the land, and which is 
the result of a practice founded in error, its 
tendency being only to evil. The idea of destroy- 



DESTRUCTION OF THE NERVE. 121 

ing the nerve and blood-vessels of a tooth so 
diseased, as to expose them to the action of caustic 
substances, and which, when destroyed, take away 
the very essential principles without which there 
can be no organic animal life, for the purpose of 
preserving the usefulness of these organs, is per- 
fectly preposterous. Experience in this matter, as 
in all others, is the best of teachers. Although, 
as in the case referred to, individuals may not be 
aware from whence their afflictions come, at least 
nine cases of every ten where the teeth are at- 
tempted to be remedied by this process, result in 
far more injury and inconvenience than would be 
realized by submitting at once to their removal. 
And even the tenth case is always more or less 
problematical. As a general practice, therefore, 
in all ordinary cases of diseased teeth, when they 
have become painful from exposure of their nervous 
pulp, or when disease of the membrane lining 
the dental socket especially has taken place, 
entire removal is the only proper course, and 
the one which experience sanctions, as contributing 
most to health and happiness ; the end desired 
by all. 

6 



122 THE EXTRACTION OF TEETH. 

THE EXTRACTION OF TEETH. 

The extraction of the dental organs has become 
so common, and is generally considered so simple 
an operation, that any remarks which may be made 
in relation to it, may perhaps be considered entirely 
superfluous. But simple as this operation is con- 
sidered, being frequently consigned to persons who 
can lay no just claims to professional knowledge, it 
is one nevertheless which requires for its judicious 
and safe performance as much care and firmness, 
and as correct an acquaintance with the anatomy 
of the parts concerned in it, as many of the opera- 
tions of surgery, to which a much higher degree of 
importance is usually attached. It may perhaps 
be granted that, in by far the majority of instances, 
this operation is performed by mere mechanical 
force, without any very serious consequences occur- 
ring ; but it is no less true, that in the most simple 
cases, the pain of the operation may be greatly 
diminished by a judicious choice and application of 
the instruments used ; while the frightful results 
which sometimes accrue from the employment of 
ill-directed violence forcibly point out the necessity 



THE EXTRACTION OF TEETH. 123 

for some degree of surgical skill to render it at 
once safe and successful. Every country village 
has its legends of the loss of portions of broken 
jaw-bones — the extraction of sound teeth in mistake 
for the decayed ones — and various diseases which 
are attributed with greater or less truth to this 
cause, and for which some ignorant pretender has 
to atone. It is not, however, to such characters 
that the censure of the ignorant performance of the 
operation in question is exclusively due. The ill 
effects of that inattention, with which medical men 
in general view the treatment of the teeth, are in 
no case more conspicuous than in this. It may not, 
therefore, be amiss, to point out the errors into 
which practitioners have fallen, and lay down a 
few general rules as guides, as to under what cir- 
cumstances, and in what manner, this important 
operation should be performed. 

When a tooth has become so far diseased as that 
its nervous pulp filling its internal cavity has 
become exposed to external influences, and thus 
rendered painful and troublesome, any effort that 
ingenuity and skill may attempt to restore it to 
health and usefulness will, as I have shown, in a 



124 THE EXTRACTION OF TEETH. 

great majority of instances prove abortive. In 
cases of this kind, which are partially successful — 
and in all such cases success can only be partial — 
the improved condition which is restored is usually 
of short continuance. And attempts of this kind 
frequently produce a thousand times more suffering 
than their removal, and in most cases the necessity 
for extraction becomes absolute after all that can 
be done to avert it. It may be laid down, therefore, 
as a safe and judicious rule, of general applicability, 
that a tooth when from exposure by disease of its 
internal cavity is rendered useless for the purpose 
for which it was designed, or even partially so, 
should be at once extracted. Were this adopted 
as a general practice, the amount of suffering which 
would be thus averted is beyond calculation. But 
there may be, and frequently are, exceptions to this 
rule. Cases occur in which it may be necessary 
to adopt the less of two • evils ; and the removal of 
the diseased member may be the greater. But 
these do not affect the correctness of the rule, which 
requires that every tooth, root, or part of a root, 
which has been deprived of its vitality by disease, 
should, for the well being of its possessor, be en- 



CUTTING THE QFM. 125 

tirely removed from their connection with the 
mouth. 

The fact should always be borne in mind also, 
that the extraction of a tooth produces, compara- 
tively, but little pain when this operation is effected 
previous to inflammation being excited in the mere 
vascular parts in close proximity to it. To avoid 
the extreme pain of this operation, then, it is of 
considerable importance to select the proper time 
for its performance. 

CUTTING THE GUM. 

As auxiliary to the operation of extracting teeth, 
cutting the gum, as it is termed, is considered by 
most practitioners in this department of surgery a 
prerequisite. 

It is generally supposed to facilitate the removal 
of the tooth, to first make an incision in the gum 
around it, previous to applying the extracting in- 
strument; and it has long since passed into a 
proverb, that " a tooth to be drawn must be cut to 
the bone." It is the practice, therefore, w T ith most 
dentists and physicians — and, indeed, various trades- 
men, for the accommodation of their neighborhood, 



126 CUTTING THE GUM. 

engage in this department of Dental Surgery-—" to 
cut the tooth loose" by passing a gum lancet con- 
structed of a peculiar form for the particular pur- 
pose, or a pocket knife down deep into the gum 
around the doomed tooth. This, as performed by 
n£my, is a very formidable operation. It is indeed, 
in most instances, a very painful one. I have heard 
many persons, who have submitted to have teeth 
extracted, speak of this part of the operation as 
far more dreadful than the removal of the tooth 
afterward. I have frequently known individuals 
who have applied to me to extract a tooth, hesitate 
to undergo the operation, until I assured them that 
the cutting was unnecessary, when they would 
readily yield, stating this to be the only part which 
inspired them with dread. 

But what is to be gained by this operation ? If 
it is painful, tl^e should be some commensurate 
good growing out of it, or else the practice should 
be at once abandoned. The loss of these useful 
organs is painful enough at best, and it becomes 
the dental profession to see to it that it is not un- 
necessarily increased. What benefit, then, I ask 
again, is to be derived from this operation? I have 



CUTTING THE GUM. 127 

shown that the root of each tooth is set in a bony 
socket which invests it perfectly ; that the margin 
of the socket terminates in the gum, which is of a 
yielding structure; that the gum, although sur- 
rounding the neck of the tooth, still has no attach- 
ment to it, its margin being free and loose. I have 
shown, also, that there is no vasuclar connection 
between the tooth and its socket, except at the 
extremity of its root, and also a small ligament 
which stretches from one side of it at its neck, and 
attaches to the margin of its bony socket. That 
this ligament is the only resistance offered to the 
removal of a tooth so far as its attachments by 
adhesions are concerned. It is perfectly plain, 
therefore, that unless the ligament referred to 
(Ligamentum Dentis) can be severed by the cutting 
operation, no possible benefit can arise from it. 
But this ligament lies entirely beyond the reach 
of instruments commonly used for the incision of 
the gums. As this operation is usually performed, 
this ligament is not molested at all, once in a 
thousand times. Indeed, it is next to impossible to 
reach it, in any case, even when the instrument is 
designed expressly for the purpose, and the atten- 



128 CUTTING THE GUM. 

tion of the operator directed particularly to that 
object. This ligament, however, as I have stated, 
offers but very little resistance to the removal of a 
tooth, none which is manifest in the operation; 
hence, it is plain, that to incise the gum, previous 
to the extraction of the tooth surrounded by it, is, 
to say the least of it, superfluous. 

But aside from the pain commonly produced by 
this operation, and the dread which it inspires, it 
is in many instances decidedly injurious in other 
respects. In cases where cutting the gum is ob- 
served, lacerations of this fleshy substance are much 
more liable to occur on extracting the tooth. It is 
especially so where the common key instrument is 
used. The individual who has had to sit patiently 
with a tooth removed from its socket, but fast to 
a portion of the lacerated gum by a fractured 
fragment of intermediate bone, to allow the operator 
to prepare his excising instrument and cut it loose, 
can alone appreciate fully the evils of this per- 
nicious and reprehensible practice. 



MATERIALS FOR FILLING TEETH. 129 

MATERIALS FOR FILLING TEETH. 

It has already been stated that the material for 
stopping the cavities of decayed teeth, in order to 
accomplish the end desired, must be indestructible, 
and not liable to chemical change. But it is 
equally essential also, that it be of such a nature 
as to be easily moulded to the exact form of each 
specific cavity, and of sufficient hardness to with- 
stand the friction usually produced during masti- 
cation. 

GOLD. 

There are a variety of substances used for this 
purpose, but of them all there is only one which 
combines all these essential qualities — pure gold, 
in the form of foil or thin sheets. This is the 
only known substance which can be said to possess, 
in any degree of perfection, the necessary proper- 
ties to effect the end desired. When of sufficient 
purity, and by the annealing process is rendered as 
malleable as it is susceptible of being made, this 
substance may be so disposed in a properly pre- 
pared tooth, as to perfectly fill its cavity to the 
exclusion of all substances, both solid and fluid, and 



130 MATERIALS FOR FILLING TEETH. 

subserve in a very high degree all other essential 
purposes. But because of the expensiveness of 
this material, others have been introduced into use. 

TIN. 

Next to gold, tin subserves best the purposes 
for stopping the cavities of teeth from which 
carious matter has been removed. It is not as 
malleable as gold, nor does it resist the corroding 
influences of the salivary fluids so well. It can not, 
therefore, be rendered as compact and solid, and, 
consequently, the protection which it affords can 
not be depended upon with the same degree of cer- 
tainty. A tin plug, under ordinary circumstances, 
will answer a very good purpose, when used for 
medium size and large cavities, from four to six 
years. It sometimes will last much longer, and in 
some instances a much shorter time. It is also 
objectionable when used for the incisor teeth on 
account of its color being dark, and when its sur- 
face becomes chemically affected, is entirely black. 
It is used in the same manner and form as gold — in 
thin sheets manufactured for the purpose called tin 
foil. Much imposition Las been and is, practiced 



MATERIALS FOE FILLING TEETH. 131 

with this acticle. Tin foil is used for various pur- 
poses which do not require that degree of purity 
necessary for dental use. Care is not taken, there- 
fore, to render it as malleable or pliable as it should 
and can be made for this purpose. Thus an 
inferior article is manufactured which possesses 
more brilliancy, and resembles much more nearly 
silver metal, than a pure article of tin. This 
spurious article of tin is frequently passed off for 
silver foil, as very few persons, comparatively, are 
sufficiently informed as to comprehend the imposi- 
tion. No evil can result, however, from this 
deception, except the los3 of the amount paid above 
the price for tin plugs, as even this inferior article 
of tin is better for the purpose of filling teeth than 
silver. But when it is known that silver in the 
form of foil or sheets is never used for this purpose, 
there will be no danger of this deception being im- 
posed upon any one. 

SILVER. 

This substance is never used for filling teeth 
except in amalgamation with mercury. Many 
persons suppose that silver, from its relative value 
and similar properties to gold, and as is stated by 



132 MATEEIALS FOR FILLING TEETH, 

dentists frequently, must hold the next position to 
this metal in point of utility. But it is not so. 
Owing to the effect which sulphurous vapor has 
upon this metal, it does not withstand the corrod- 
ing influences exerted upon it when used for the 
purposes of filling teeth as well as tin, and there- 
fore is never used, as it is also much more 
expensive. 

METALLIC PASTE. 

Various compounds have been introduced into 
notice from time to time, for the purpose of stop- 
ping the teeth. Each has had its advocates and 
its brief hour to flourish, but of them all, they can 
only be used with any degree of propriety where 
cavities are large, and the teeth from being sensitive, 
or amount of disease, will not bear the pressure 
necessary to allow the insertion of tin or gold. 

It is sometimes advisable to use something of this 
nature, but it is much more frequently demanded 
by individuals of the profession than their health 
and comfort require. There is no compound or 
substance of this nature but what is more or less 
objectionable. Any article of this kind must 
necessarily be of a soft, pliable nature, in order to 



MATERIALS FOR FILLING TEETH. 133 

fill all forms of cavities ; it must therefore possess 
the property of becoming hard after insertion. In- 
vention has sought out a variety of compounds of 
this sort. I have experimented quite extensively 
myself, in attempting to find out some substance 
that would serve as a substitute for gold, without 
its expensiveness. But this I am satisfied can 
never be accomplished. Of all the great variety 
of substances which I have been able to obtain, and 
have used as stopping, there are but two which can 
be said to be of any value. These I have used to 
some extent, and they have been extensively used 
by others. One of these, however, at the present 
time, has, I believe, pretty much gone into disuse. 

The one is a fusible alloy — composed of tin, lead, 
and bismuth in certain proportions. It is used by 
putting a piece of the compound upon the tooth 
containing the cavity to be filled, and then with a 
heated brass or copper ball melted into the cavity. 
But this substance has gone into disuse owing to 
the difficulty of its application. 

The other is an amalgam of silver and mercury, 
or quicksilver. This substance, so far as any 
article of this sort is required, is commonly used. 



mm 



134 MATERIALS FOli FILLING TEETH. 

and is probably preferable in some respects to any 
cement or metallic compound now in use for the 
purpose for which it is designed. It is prepared 
into a soft paste, and in that state inserted into the 
cavity of a tooth. In a short time it hardens suffi- 
ciently to prevent it from coming out, and in the 
course of from two to five hours becomes perfectly 
hard, and serves very well in this respect the pur- 
pose of mastication. 

As it may be of service to individuals sometimes 
to prepare this compound for themselves, I have 
appended to this work a recipe for its preparation. 

It may be well to state that all metallic com- 
pounds, wl\en used for this purpose in any consider- 
able amount in a single tooth, but more especially 
when several teeth in the same mouth are filled 
with it, are liable to induce unpleasant effects upon 
the individual by the galvanic, magnetic, or other 
mysterious influence which they are capable of 
exerting upon the nervous sympathies of the phys- 
ical system. 

Thus in the case of the lady referred to, and 
whose case is described above ; from the time her 
teeth were filled, she felt, as she stated, an un- 



ARTIFICIAL TEETH. 135 

pleasant indescribable uneasiness throughout her 
system.* 

In what manner this influence is exerted, 
whether by the establishment of an electro-mag- 
netic current connecting the metals with the vital 
organs, or by some other mysterious mode of 
operation, it is sufficient for us to know the fact, 
to enable us to avoid the evils which may result 
from it. 

ARTIFICIAL TEETH. 

That individual who has been so unfortunate as 
to suffer the loss of his natural teeth, can alone 
fully appreciate their usefulness and convenience. 

Most persons, who have not been taught by 
experience, set too high an estimate upon the 
advantages to be derived by artificial means, where 

* Teeth placed in juxtaposition, having cavities upon their 
contact surfaces filled with materials diverse in their nature : 
as for example, one filled with a metallic compound, and the 
other with one of the metals — as gold or tin — are very liable 
to attacks of neuralgia. I have known numerous instances 
of this kind. Teeth in this position, the one filled with gold, 
the other with tin, will so affect each other as to induce 
neuralgic symptoms, and even destroy, by oxydation, the two 
metals. 



136 ARTIFICIAL TEETH. 

such loss has been sustained. Neglect to apply the 
necessary means to protect the natural organs from 
the ravages of disease is frequently the result of 
this false estimate. 

The remark, " Let them go ; when they are gone 
I will have some new ones," is a very familiar one 
to the dentist; but the individual who has been 
subjected to the alternative of artificial teeth, would 
gladly accept his primitive organs again, were it 
possible they could be restored. When the sad 
reality comes, it always brings its regrets, of op- 
portunities neglected, and duties unperformed. 
There is most always disappointment more or less 
in the realization of benefits anticipated from arti- 
ficial means. This is a subject on which the un- 
fortunate ones are usually not very much disposed 
to communicate their experience, and hence the 
difficulty in obtaining correct information, until 
learned by personal application, for it must be ad- 
mitted that the utility of artificial teeth, by dentists, 
is generally over-stated. 

Science and art, however, in the hands of in- 
ventive genius, have done much to relieve, in this 
respect, the necessities of human life, and con- 



AS H . 

ate largely n the ills to which it would 

:he impro ic- 

. and ir. : of artifi: 

Uy be mad n a good d 

hich the natural c: .Tied 

For \ ■•:■: -onal appeara: in the articu- 

n of * :ae extent in the 

minution of the food prepara tor- 
rood B the 
individual - which 

i willing to relinquish them a: 
ward : ne flatter hir:. the 

adoption of these as . he be the 

recipient of an unalloyed good. Far from it. It 
may not b •: : too much to say, tfa 

D and trouble. They are. iniec 
two evils : artificial teeth, or no te 

B .mount 

of benefit derived by different individuals from : 
source. There are a great variety of circum ; 
which bear d:: d individual c :on- 



138 INSERTING ON PIVOTS. 

tribute to render them more or less vexatious. 
These circumstances need not be explained here, 
but it should always be borne in mind, that the 
benefits to be obtained from artificial teeth in any 
given case, depend altogether upon the specific cir- 
cumstances which involve it. But even where the 
circumstances are the most favorable, much and 
constant care is necessary to be observed in order 
to render them durable, and prevent them from 
becoming offensive, as, without unremitted attention, 
they soon would be. Let no one be deceived, 
therefore, and allow the opportunity to pass un- 
improved, by which the health of the natural 
organs may be secured, and rendered permanent. 

There are several methods of inserting artificial 
teeth, which dentists employ. The one which is 
the least expensive, and which was formerly the 
most common, is that usually termed — 



INSERTING ON PIVOTS. 

This method of inserting teeth was formerly 
much more extensively employed than at present, 
although many dentists, especially itinerants, still 



INSERTING ON PIVOTS. 139 

continue to recommend and practice it to a greater 
or less extent. 

The operation is accomplished by cutting off the 
natural tooth at its neck, or at the point on the 
same level with the margin of the gum, enlarging 
the orifice through which the vessels and nerve 
pass, and attaching an artificial tooth constructed 
for the purpose to it, by a wooden pivot inser.ted 
into both the root and artificial crown or body. 

The natural tooth, when attacked by disease, 
usually decays and breaks of itself so much, that 
the cavity containing the nervous pulp is exposed, 
and the nerve destroyed, from exposure to external 
influences, in a gradual manner. During this 
process, the membrane covering the external surface 
of the root, as well as the soft tissues immediately 
at the extremity of it, become inflamed, and fre- 
quently ulcerous ; so that alveolar abscess, or what 
are commonly termed gum biles, appear upon the 
gum opposite the root of the affected tooth. When 
once a tooth takes on this condition, it usually con- 
tinues to keep up a discharge from the gum, with 
occasional intermissions, until the root is removed 
from its socket. But the vitality of a tooth fre- 



140 INSERTING ON PIVOTS. 

quently becomes destroyed without ulceration and 
the abscess referred to. Teeth which have become 
thus diseased, both with and without ulceration, 
are frequently filed down level with the gum, and 
thus prepared for the reception of an artificial 
crown or body. A large majority of pivot teeth 
are inserted upon roots like those described above, 
and not unfrequently are they so decayed as to 
render it difficult to fasten a tooth even for a few 
months. 

When teeth are thus treated, which have never 
induced ulceration previously, they now are very 
liable, from the excitement induced by this opera- 
tion, to become inflamed and ulcerous, and produce 
more or less swelling of the soft parts contiguous 
to them. 

But there is another condition of the teeth which 
frequently becomes the subject of consideration. 
They frequently decay, so that the crown becomes 
so far diseased as to destroy their polished surfaces, 
and render them uncomely, and a source of morti- 
fication to the feelings of their possessors, while yet 
their vitality remains, and the nervous sensibility 
is unimpaired. This is the case with front teeth, 



INSERTING ON PIVOTS. 141 

or those which are exposed to observation. It will 
be recollected that none but those which have but 
one root are ever subjected to the operation of 
excision. To subject a tooth in this condition to 
the operation of excision, and preparation to receive 
an artificial body, must necessarily excite consider- 
able pain. But notwithstanding that such is the 
case, it is frequently done. 

To accomplish this operation under such circum- 
stances with the least possible pain, the operator, 
with a pair of cutting pliers, or what are called 
bone forceps, cuts the tooth square across at its 
neck, sufficiently far up to expose the nervous pulp 
contained in its cavity. This operation of excision 
produces by its concussion, for the time, a partial 
paralysis of the nervous sensibility of the root, and 
while in this palsied state, a small instrument is 
thrust into its cavity, and by a dexterous twirl the 
nerve, which has the appearance of a small white 
filament or thread, can usuallv be extracted from 
the whole length of the root. 

To destroy the nervous pulp ,of a tooth in this 
manner is always more or less painful ; but as it 
sometimes happens, circumstances prevent its im- 



142 INSERTING ON PIVOTS. 

mediate destruction, and when this is the case, the 
pain is generally very intense 

When, the sensitive nervous substance which fills 
the cavity of a tooth is paralyzed by disease or 
otherwise, there is no further pain of any account 
during the operation or inserting a pivot tooth. 

So far as the appearance of teeth inserted in this 
manner is considered, when inserted as they may 
be, there can be no objection urged ; but the im- 
portant question to be decided in relation to pivot 
teeth, is, does the benefit to be derived from them 
justify the exposure of the health, and in many 
cases even the life, to the dangers to which every 
one is subjected who submits to this operation'? 

In many instances teeth inserted in this manner 
seem to do very well. They retain their position, 
and answer every purpose that the natural ones 
could accomplish so long as they thus remain, and 
in some cases they have been retained for a long 
number of years. But although they subserve a 
very good purpose in some cases, they are liable 
to induce serious consequences in all instances. 
Indeed, there are no appreciable circumstances, 
however favorable, that will enable an individual 



INSERTING ON PIVOTS. 143 

i 

to calculate with any degree of certainty upon a 
favorable issue in any particular case. The excite- 
ment produced by the excision, by filing down the 
stump, and drilling the orifice into it, especially 
where there is disease at the extremity of the root 
in its first stage of development, in a majority of 
cases, results in very unpleasant consequences. 
Inflammation of the parts liable to such a condition, 
swelling and ulceration of them, with intense pain, 
and, in many cases, general irritative fever super- 
venes. These may be said to be extreme cases, 
but they are not unfrequent. 

If, after the first excitement of inserting was 
past, the certainty of future exemption from similar 
paroxysms could be calculated upon, this method 
of inserting teeth would not be so objectionable; 
but the first excitement may pass without any 
serious occurrence, and yet, on the accession of any 
undue excitement from exposure, to the common 
causes of disease to which all are more or less sub- 
jected, the same difljpulty may even arise, and the 
individual always be liable to gll the affections 
which have been referred to as resulting from dis- 
eased teeth, or roots remaining in their sockets. 



144 INSERTING ON PIVOTS. 

This operation of inserting teeth on pivots, as I 
have already stated, is practiced to some extent by 
all dentists, and yet its propriety under any cir- 
cumstances is very questionable. Some of the most 
eminent of the dental profession in our country 
have testified decidedly against it. 

Formerly, my own practice was to adopt this 
method in all cases where roots were found of suffi- 
cient firmness to warrant it, for this was the 
instruction I had received. 

But from the observations which I have been 
enabled to make, I am satisfied that in all cases it 
is an operation of very doubtful propriety. I have 
not, therefore, for some years past, practiced it, 
except in some particular cases, and then with the 
greatest caution. Having stated to the individual 
making application the probable results, and also 
those which may arise, and all the precautionary 
measures necessary to be observed, I sometimes, 
in cases of circumstances the most favorable, venture 
upon it. ^ 

But it will be remembered that the evils to be 
apprehended from this operation do not always 
consist in violent manifestations of disease. This 



INSERTING ON PIVOTS. 145 

is frequently the case, but as often they are insidious 
in their approach, giving no convincing evidence to 
the afflicted one, that the teeth are the source from 
whence they originate. I have known many instances 
where the health of individuals had been rendered 
miserable for years, disease manifesting itself under 
the various forms which neuralgia assumes, and all 
arising from this source, and not even a thought 
had ever suggested the true cause. Whenever, 
therefore, neuralgic affections arise, and there is 
any reason to apprehend that diseased roots of teeth 
are concerned in their production — and the simple 
fact of their presence is always sufficient to excite 
suspicion — they should be immediately removed. 
This is the only safe course, and would be found 
much more frequently an efficient remedy than 
many are willing to believe. 

If this method of inserting teeth is beset with so 
many difficulties and dangers, why, it may be asked, 
when there are other methods by which the loss of 
these organs can be supplied, should it be resorted 
to in any case ? I know of but two reasons which 
may be urged in its favor. The one is, the un- 
willingness which many persons cherish, through 

7 



146 INSERTING ON PIVOTS. 

fear, of having decayed teeth extracted. They will 
suffer with the toothache a thousand times more 
than the pain of having them removed, and yet in 
the event, be compelled to submit to the dreaded 
operation. The roots of teeth, where artificial 
bodies are inserted upon them, after the first excite- 
ment or that produced by inserting is past, are 
generally not more liable to be troublesome than 
they would be under other circumstances ; and, 
therefore, if individuals will not have them removed, 
it is well, perhaps, under such circumstances, that 
this mode, so far as it can be made efficient in repair- 
ing a loss, which, as before stated, no one can 
appreciate but he who has learned in the school of 
experience, should be adopted. 

The second reason is, teeth are less expensive 
inserted in this manner than in any other, if merely 
the cost of the one operation — placing the artificial 
crown upon the root is taken into the account. 
But I apprehend, that if a just estimate of the 
depreciated condition of the physical energies 
could be obtained, it would be found in a great 
majority of cases to be far more expensive than 
any other. 



INSEBTIXG TEETH OX PLATE. 147 



INSERTING TEETH ON PLATE. 

This method of repairing by artificial means the 
loss of the natural organs, differs essentially from 
that described above. Instead of using the roots 
of the teeth as supports, they are removed entirely 
from their sockets, and the wound produced by this 
operation allowed to heal. A metallic plate is then 
fitted to the gum, upon which the artificial teeth 
are fastened. The manner of attaching the teeth 
to the plate is essentially the same under all cir- 
cumstances in which plates are used ; but the way 
by which plates are sustained in such a position as 
to exhibit the teeth so as to represent nature, 
depends entirely upon the circumstances involving 
each individual case. There are three methods, 
however, of fastening or sustaining plates in their 
position, which differ in principle, by one or the 
other of which all are operated. 

By the one method plates are sustained by clasp- 
ing to the natural teeth. It will be observed, 
therefore, that this method can only be applied 
to the insertion of parts of sets, as there necessarily 



148 INSERTING TEETH ON PLATE. 

must be more or less natural teeth remaining for 
this purpose. 

By another method, they are retained in their 
position by atmospheric pressure, or what is com- 
monly called suction. In this manner they can be 
inserted without reference to the natural teeth, and, 
therefore, the number of teeth to be supplied is not 
material, as it is applicable to a single tooth as to 
an entire set. 

For inserting whole sets, or half sets, this mode 
is now commonly employed ; indeed, a case seldom, 
if ever occurs, where a whole or half set is required, 
but this is found to be the best manner of supply- 
ing them. 

There is another method, however, which was 
formerly used altogether for sustaining whole sets, 
and is employed by some dentists at the present 
day, but will probably go entirely into disuse as 
the way referred to above comes to be practiced. 
By this method plates are sustained in their posi- 
tion by double springs, or rather by springs bent 
upon themselves, one or the other end of which 
being attached to either plate, operating between 
them, in a direction to press them from each other. 



INSERTING TEETH ON PLATE. 149 

The force thus exerted, tending to separate the 
upper from the lower plate, serves to keep them in 
contact with the gum to which they are fitted. 

The first of these three methods mentioned above, 
of preparing plates, is much more frequently em- 
ployed than the others, as there are few half or whole 
sets, comparatively, to be inserted, and as any 
number of teeth less than half a set is seldom pre- 
pared in any other manner, although, as already 
stated, a sucti a plate is applicable to one tooth or 
more. Plates attached to the natural teeth can 
generally be rendered more firm than by any other 
mode of inserting, and while the teeth remain sound 
to which they fasten, they usually are of important 
service. There is an objection, however, to plates 
sustained in their position in this manner. 

The teeth to which the clasps are attached, fre- 
quently very soon decay, owing to the irritation 
produced, and thus they are rendered useless by 
the excitement w T hich they themselves have induced. 
In this particular, the skill of the dentist manifests 
itself in a greater or less degree. The exercise of 
practical good sense on his part, in the form and 
adjustment of the plate, in most cases makes a 



150 INSERTING TEETH ON PLATE. 

material difference in the service and durability of 
these artificial organs. But no specific directions 
can be given in their preparation ; this must be left 
to the judgment and skill of the practitioner, who 
should always consult the interests of his employer 
in this matter. 

The objection to a suction plate is its expensive- 
ness. To prepare a plate of this kind, a large 
amount of material is necessary, as the more ex- 
tensive the surface the more firmly the plate will be 
retained in its position ; and as they are commonly 
of a costly material, the expensiveness is frequently 
an important item to be considered. It requires 
nearly as much plate to insert a single tooth in this 
manner, as half a dozen. This method is much 
more frequently employed now, however, than for- 
merly; and as the preparation of plates formed 
upon this principle become improved, they will 
finally, probably, supersede the employment of all 
others. 

I have stated that a very serious obstacle in the way 
of the general adoption of this method of inserting 
artificial teeth is its expensiveness. To obviate this 
objection to some extent, dentists, or some of them, 



INSERTING TEETH ON PLATE. 151 

are in the habit of using much less material in 
quantity than is necessary to make them substantial 
and useful as artificial teeth may be made. But it 
is not always that a liberal or even an exorbitant 
price secures the proper quality or amount of 
material for this purpose. It is to be regretted 
that so many dental practitioners yield to tempta- 
tions which this department of mechanical dentistry 
places before them. 

As was stated in regard to plugging teeth, that a 
cavity could be filled with at least one half the 
amount of material which the necessity of the case 
required, and yet the individual most interested be 
entirely ignorant of its real condition, so in respect 
to plates used for the purpose of sustaining artificial 
teeth ; they are frequently made so thin, that they 
do not last but a very short time. Plates are 
sometimes alloyed, and rendered so impure as to 
be objectionable ; but they are much more frequently 
made so thin as to spoil them, and yet the fraud 
may not be detected. A plate made very thin, 
when moulded to the form of the gum from a correct 
impression, will set easier and seem to fit better 
when first applied, than in cases where they are 



152 INSERTING TEETH ON PLATE. 

made more thick and firm ; and generally individuals 
with such a plate are for the time better satisfied 
than under other circumstances they would be ; and 
it may be a year or two perhaps before the paucity 
of material manifests itself by the giving way of the 
plate. The dentist, by a little management, may, 
and frequently does, retain at least fifty per cent, 
of the material which should enter into the con- 
struction of plates ; and yet for the want of the 
necessary information, few individuals are qualified 
to determine, except by the test which time and 
application afford, their constitution, whether they 
are properly arranged and substantially constructed 
or not. I have seen plates upon which teeth were 
placed which could not be mended with solder of 
ordinary purity, because of their being so thin. 
Heat from the blow-pipe, sufficient to melt the 
solder, would burn or melt the plate through as 
paper. The quality of the plate, however, usually 
contributes very much to this result. A plate re- 
duced in quality to sixteen or fourteen carats fine, 
requires to be made more thin than when it is 
purer, as the more gold is alloyed the more hard 
and unyielding it becomes ; and a plate thus reduced 



INSEETING TEETH ON PLATE. 153 

is rendered very difficult to be impressed with the 
exact form of the gum which is necessary, if made 
of the same thickness of plate when alloyed, as it 
should be. 

There is a practice which many dentists adopt, 
but more particularly the itinerant class, of filing 
the decaying roots of teeth down to the gum, and 
fitting plates over them. This is a very pernicious 
practice, and admits of no excuse. Teeth can not 
be inserted immediately, without allowing time for 
the gums to heal after the operation of extracting, 
and the dentist may thus, perhaps, secure a job 
which he might otherwise lose ; but for a dental 
practitioner at all acquainted with his profession, 
to recommend such a course, and practice it, is 
assuming rest onsiblities which can but weigh heavily 
upon his moral sensibilities ; for there is added to 
the continual trouble arising from the constant 
change which takes place in the roots of the teeth 
and gums, and consequent displacement of the 
plate, all the long catalogue of evils commonly 
arising from the diseased roots of teeth, increased 
by the excitement which the pressure of the plate 
under such circumstances always produces. This 

7* 



154 INSERTING TEETH ON PLATE. 

practice is, indeed, the most reprehensible of any 
one which the cupidity of individuals engaged in 
this business has tempted them to adopt. Language 
can not adequately describe the filthiness of such a 
condition as is thus produced, and yet many pro- 
fessed dentists practice it whenever the circum- 
stances will admit. One very important objection 
to teeth inserted upon pivots, is the putrid exhala- 
tions which they engender, and which renders them 
very offensive ; but teeth sustained in this manner, 
with the roots remaining in situ, are as much worse 
as can well be imagined. 

Individuals, therefore, who are unfortunate in the 
loss of their teeth, and have recourse to artificial 
means to repair the want, will do well to see to it, 
that all decaying teeth which can not be improved 
by plugging, and all roots of teeth, be entirely 
removed, and the gums healed perfectly, before 
a plate is prepared for the sustaining of the 
artificial teeth. 

To avoid all unnecessary weight, plates should 
be made, as a general rule, as thin as they 
can be, and possess the requisite strength and 
firmness to prevent them from yielding to the 



COMPOSITION OF PLATES. 155 

pressure to which the circumstances in which they 
are placed would subject them. But plate had 
better be unnecessarily heavy, than to be too light 
and yielding. 

COMPOSITION OF PLATES. 

Of the various metallic substances which have 
been used for the manufacture of dentists' plate, 
there are but three which claim particular notice. 
They are gold, platina, and silver. Of these, gold 
is more commonly made use of, and, indeed, is the 
only metal which is not to considerable extent 
exceptionable. Other metallic substances have 
been used to some extent, as cadmium, palladium, 
etc. ; but they possess no qualities which invest 
them with any superiority over the three referred 
to, and in many respects are decidedly inferior. 
They are, therefore, but little used, and need not 
be discussed here. 

It is of considerable consequence, however, that 
the relative importance of the three substances 
referred to should be well understood. There is a 
great difference in value of these metals, and it is 
of importance to know why the cheaper will not 



156 SILVER FOR PLATE. 

subserve the same purpose as the more valuable. 
The expensiveness of teeth upon plate limits very 
much the extent of their employment. By the 
employment of silver, this objection could be in a 
great measure removed. 

The inquiry is frequently made, therefore, of the 
dental practitioner, " Why will not silver answer as 
well as gold 1" Knowing the properties possessed 
by the various metals used for this purpose, it is 
only necessary to ascertain the various causes, 
which are brought to act upon them, in order to 
determine their relative fitness for plates to be worn 
in the mouth. 



SILVER FOR PLATE. 

It has been stated on a former page, that the 
fluids of the mouth produced by the salivary glands 
hold in solution, in greater or less quantity, in all 
cases varying according to circumstances, the sul- 
phate of lime. It is also stated, that during the 
process of the putrefactive fermentation, sulphu- 
reted hydrogen, or sulphurous vapor is disengaged. 
It is evident, therefore, that in all cases of a plate 



SILVER FOB PLATE. 157 

worn in the mouth, it would come in contact with 
sulphurous vapor from these sources. Now it is 
well known that silver is readily affected by the 
fumes of sulphur, that it will soon tarnish, and 
when exposed for any considerable length of time 
to its influence, it will become perfectly black. 
This effect, then, is just what we should expect to 
take place on the exposure of a plate of silver to 
the continued operation of the salivary fluids, and 
this is just what we do find to some extent in all 
cases where a silver plate is used for sustaining 
artificial teeth. There is a great difference, it is 
true, in the effect produced upon plates when worn 
by different individuals. With some, it is but 
slightly affected, and if frequently polished, a plate 
of this metal answers a very good purpose; but 
with others, a few hours is sufficient to tarnish and 
even blacken it. A very unpleasant taste in the 
mouth is also generally produced when this is the 
case ; and frequently so much excitement is produced, 
that constant soreness of the parts is kept up which 
come in contact with the metal. I have known 
instances where, in the course of three or four 
years, thick substantial silver plates were so affected 



158 F LATIN A. 

by chemical action, as to be rendered perfectly use- 
less. These influences vary also in the same 
individual, according to circumstances. A plate of 
this kind may at one time be worn without any in- 
convenience, and a change in the condition of health 
may render it very obnoxious at another. 

But silver plates are never employed, except to 
avoid expense ; and it can never be determined by 
any ordinary means whether a plate of this sort 
can be worn with any degree of comfort or not, 
except by actual experiment. 

Whoever, therefore, to economize, resorts to silver 
plate for this purpose, risks not only the pecuniary 
cost to which he is subjected, but the comforts 
which these artificial organs under other circum- 
stances might afford him. 

PLATINA. 

This metal is not liable to the same objections 
which have been referred to as pertaining to silver. 
It resists the chemical action of the salivary fluids 
equally as well as gold; but there are objections to its 
common use which this metal has not, and it possesses 
no qualities except in one particular but what it has. 



PLATINA. 159 

Platina is the heaviest known substance. It is 
much heavier than gold, and in its unalloyed state, 
when rolled into plate, is softer, and requires to be 
thicker than that metal, and it is equally as expen- 
sive. It possesses one characteristic, however, 
which renders it preferable to all other metals for 
sustaining teeth set in blocks. It does not melt or 
change under the most intense heat of the blow-pipe 
or furnace. Artificial teeth, when set in blocks, are 
commonly moulded to a plate of platina forged to 
the shape of the gum, upon which it is to rest in 
supporting the blocks. These blocks of artificial 
teeth are necessarily subjected to an intense heat 
in their preparation, which would melt gold, and 
spoil its form. As an intense degree of heat, there- 
fore, is necessary in the manufacture of sets of block 
teeth, platina is always used for this purpose. It 
is also used for pivots in the manufacture of single 
teeth. 

In no other respect than the one referred to 
above, is this metal equal for any purpose for which 
the metals are applied in the manufacture of arti- 
ficial dental organs, to gold. It is heavier, softer 
when unalloyed and therefore is more easily dis- 



160 GOLD. 

placed, and, owing to its being so difficult of fusion, 
is not readily alloyed with other metals ; but when 
thus alloyed with gold, a hard elastic compound is 
produced, which when rolled into plate does not 
receive impressions as easily as alloys of gold and 
other metals which are cheaper and equally as good. 



GOLD. 

The objections which have been urged against 
silver, and other metals, as plates for sustaining 
artificial teeth, can not be said to be entirely in- 
applicable to any extent to this one. Pure gold, 
or gold of twenty-four carats fine, under all 
ordinary circumstances, will not tarnish when worn 
in the mouth, if there is any attention at all paid 
to cleanliness ; but gold, when pure, like platina, is 
too soft, and unless made very heavy, yields too 
readily to the necessary pressure it commonly is 
required to sustain. 

It also wears very fast when thus pure, to 
obviate which it is usually alloyed with other metals. 
It also readily amalgamates with quicksilver ; and 
instances occur (I have known several such) in 



GOLD. 161 

which the system has become so impregnated with 
mercury, that plates of gold, worn for dental pur- 
poses, have become very much affected by it. With 
these exceptions — the first of which, by properly 
alloying with other metals, can be remedied — every 
object may be fulfilled, which is attainable by arti- 
ficial means, in the employment of gold plates. It 
is of all others far the best, and is most commonly 
used for dental purposes. 

Gold, however, is a costly material, and is an 
item of important consideration to the dentist. It 
has become very common, therefore, in these latter 
days, for him, or at least some of them, to prepare 
material for plates purporting to be of gold, but 
which is of an inferior quality, and frequently of 
so base a quality as to be entirely unfit for the 
purpose under any circumstances whatever. Plates 
of other metal than gold are galvanized to represent 
this metal, and palmed off upon individuals as 
genuine material, with the design to convey the 
impression that they are only afforded at a cheaper 
rate. 

This statement may be confirmed ; and perhaps 
it can not be better illustrated than by inserting 



162 GALVANIZING. 

here an advertisement from the Semi- Annual Dental 
Expositor, for November 1, 1852, published in the 
city of New York, and sent to all dentists in the 
United States. It is as follows : 



"GALVANIZING. 

" Dentists wishing their work in any other metal 
than gold, or in gold of inferior quality , galvanized 
with pure gold, are invited to forward the same by 
express or otherwise. 

Charges for whole upper or lower set $1 50 

■« " a double set 2 50." 

The process of galvanizing, it will be understood, 
consists in precipitating upon a metallic plate, 
upon which artificial teeth are placed, whether of 
silver, or an inferior quality of gold, immersed 
in a solution of gold, in nitro-muriatic acid, by 
electro-galvanism. Metallic plates thus circum- 
stanced in a solution of gold, soon receive a perfect 
coating of pure gold. Watches with silver and 
copper cases, it is said, are thus prepared for the 
mock auction. Silver plates thus gilded, by two 
or three weeks' wear in the mouth, will discover the 



GALVANIZING. 163 

deception ; but plates of gold of inferior quality pre- 
pared in this manner, if the alloy contains a con- 
siderable amount of copper, will wear some months 
without detection, except from the unpleasant taste 
which this metal creates. The object in view, in 
the performance of this galvanizing process, can 
hardly be designed but to deceive, for it can be of 
no possible benefit to the material or the workman- 
ship, and gilding produced in this way by precipi- 
tation can not be durable. Although plate-work 
prepared in this manner may add to its beauty a 
temporary lustre, yet its value is not in the least 
augmented. 

But gold for dentists' use is commonly alloyed 
with other metals. The quality usually regarded 
as the standard for dentists' plate is plate alloyed 
to eighteen carats fine, or plate containing eighteen 
parts of pure gold in every twenty-four parts of 
gold and alloy. The reducing alloy commonly used 
is equal parts of copper and silver. Therefore a 
pwt. of dentists' gold, most commonly used for sus- 
taining artificial teeth, consists of eighteen grs, 
pure gold, and six grs. of copper and silver. This 
composition answers very well in all ordinary cases. 



164 GALVANIZING. 

It makes a plate sufficiently hard and elastic to 
prevent wearing rapidly, and yielding too much to 
pressure, without requiring a thickness so heavy and 
clumsy as to render it inconvenient. 

There is an objection, however, to this proportion 
of gold and alloy. 

In order to prepare a solder sufficiently easy of 
fusion, to be used on plate of the composition stated 
above, it becomes necessary to reduce it so low, 
that in cases where much is used in soldering on 
teeth, etc., it forms a very serious objection. In 
cases where a base solder is employed, artificial 
teeth are frequently rendered very unpleasant to 
wear by it. 

To obviate this difficulty, I have been in the 
habit, for a number of years past, of preparing my 
own plates in the following manner, which I find to 
accomplish the desired object. It allows the prep- 
aration and use of a solder sufficiently pure to 
prevent all the disagreeable effects which otherwise 
would be liable to arise. . 

I compose my plate of twenty parts gold and 
four parts silver, using the common silver coin. A 
solder for this plate, composed of eighty parts of 



ARTIFICIAL TEETH. 165 

gold coin of the United States, twenty parts silver, 
and twenty parts copper, is much finer than is com- 
monly employed by other dentists. But it melts 
sufficiently easy, and does not tarnish, or produce 
the disagreeable taste which so frequently occurs 
with other solders of a baser kind. 



ARTIFICIAL TEETH: THEIR COM- 
POSITION. 

Formerly, human %nd animal teeth were arti- 
ficially prepared, and altogether used to repair the 
loss of the natural organs. But these were subject 
to decay, and cases are recorded of fatal diseases 
being contracted by their influence. In the progress 
of general improvement, however, this subject has 
not been forgotten 

Invention and improvement in the dental art 
have kept pace with those of all the other arts and 
sciences ; and porcelain teeth have now, within a 
very few years, succeeded, to the entire exclusion 
of all others. They have gradually improved, 
until, at the present time, art and science have far 
outstripped nature in this respect, and the works 



166 artificial teeth: 

of art can now only be distinguished by their 
superior beauty and grace. 

The composition and process of manufacturing 
artificial teeth are very similar to that of porcelain 
or common china ware. The main body or portion 
of teeth consists of a kind of clay, called kaolin, 
prepared and pressed into moulds, in form like the 
teeth. It is then taken from the moulds and dried. 
In this state it is colorless. The particular tinge 
or shade of color is now applied, and then a trans- 
parent enameling, composed 4>f silicious and other 
substances, is applied upon that part of the tooth 
designed to be exposed to view. The teeth are then 
placed upon platina racks, and subjected to an 
intense heat of a furnace sufficient to flux the en- 
ameling. This produces a smooth surface, and 
protects the coloring matter from the action of all 
chemical agents which may subsequently be brought 
in contact with the teeth. 

What are called plate teeth, when moulded, have 
two platina pins or pivots imbedded in their sub- 
stance, one end of each of which projects from 
their inner surface, and serves to attach them to the 
plate which is to sustain them. Those which are 



THEIR COMPOSITION. 167 

designed for pivot teeth, instead of platina pivots, 
have an orifice for receiving a wooden pivot. Sets 
of teeth made in blocks are made in the same 
manner, except they are joined together, or are 
carved in blocks of several teeth each. 

Artificial teeth, manufactured as stated above, 
are prepared to endure an intense degree of heat, 
and in the process of attaching them to plate they 
are always subjected to a sufficient degree to melt 
gold, which they endure without change in any 
respect. Great care is required, however, in the 
performance of this heating process, to prevent 
breaking the teeth in pieces. This is especially 
necessary in heating them after they have previously 
been attached to a plate, as is sometimes the case 
in mending, etc. 



RECIPES. 



Eecipe— No. t 

COMPOUND TOOTH PASTE, 

Precipitated Chalk 1 lb. 

Rose Pink * " 

Ground Orris Root £ M 

Pulverized Myrrh — Gum 1 oz. 

" Gum Arabic 2 " 

" Calcined Alum 1 *■ 

Castile Soap 2 " 

Tincture of Cochineal 1 " 

Clarified Honey 2 lbs 

In the preparation of this compound, the honey 
is first to be made hot, in a pan sufficiently large 
to mix all the ingredients, over a sand bath ; the 
other articles in powder well mixed together — except 
the tincture of Cochineal — are then to be gradually 



RECIPES. 169 

stirred into it, the tincture being added during the 
process, and also — 

Of the Oil of Bergamot 1 dram. 

or any other essential oil as shall suit the taste of the 
individual. All of which is then to be kneaded into 
a hard paste and placed in boxes, sealed air-tight. 

This preparation may be perfumed without de- 
tracting from its virtues, and thus rendered more 
congenial perhaps to the senses of some individuals ; 
but for general use as a dental remedy, in the 
ordinary condition in which the organs treated of 
in the foregoing pages commonly appear, I believe 
there has never been any combination of remedies 
for this purpose introduced to the public which 
equals it. Such, indeed, is the testimony of those 
who have resorted to the daily use of it for the last 
six or eight years. 

In its preparation, the directions should be strictly 
followed. 

I subjoin a recipe for the preparation of tincture 
of cochineal, which enters into the above compound. 
This of itself alone I have frequently found very 
efficacious in relieving pain when applied to an 
aching tooth. 

8 



170 liECIPES. 

fteripe— No. 2. 

TINCTURE OF COCHINEAL. 

Cochineal 1 oz. 

Diluted Alcohol 8 oz. 

Macerate the cochineal in the proof spirit twelve 
hours, and it is ready for use, 

ftuipt— No. 3. 

The following will be found an elegant tincture 
for the teeth : 

Bruised Orris Root 4 oz. 

Cloves -• £ oz. 

Essence of Ambergris 1 oz. 

Gum Myrrh J oz. 

Alcohol 1 pt. 

Digest two weeks in a warm place, being occasion- 
ally shook up. It should then be filtered, and the 
liquid placed in a bottle, and kept closely corked 
for use. 

Ten or fifteen drops of this preparation in half a 
wine-glass of water, makes a very pleasant, agree- 
able, and useful wash for the mouth, when used 
with a tooth-brush of a proper quality, such as has 



R. 171 

I hare prescribe 

ver? > for several years, in cas e ^ght 

derangement of the gums, or where there was a 
want of tone in these parts, and alwn 
satisfaction of my patient. 

Secipc— 3Tc. i. 

:ra>e of Bf Lnn£ . : 

illed, or rain water 

The can-: ". be d: .in the water, and 

applied to the diseased gums and teeth with a 
camePs-hair pencil. 

This preparation will be be a- most 

:edy when appl swollen, 

irritable, and highly ve gums of childre: 

common during the >n. I fa 

] in many cases where, 
from the effect of tartar and other causes, the gums 
had become swollen and excessively irritable, after 
having removed the tartar with the scaling instru- 
mei cquently, in c 

of the teeth are inflamed, and very sensitive. In 
such ii -, this in- 



172 KECIPES. 

creased in strength, with benefit, to ten grains to 
the ounce; and may be applied as a gargle, by 
adults. Two or three applications of this remedy, 
however, are all that are generally advisable, and 
if other means, as the compound paste, etc., are 
thoroughly applied afterward, these will in most 
cases be sufficient to effect all that may be obtained 
from remedies. 

Care should always be exercised in using this 
article, as it produces an indelible stain upon the 
skin or linen with which it comes in contact. 

ftecipe— No. 5. 

The following preparation I have -used for the 
purpose of deadening and destroying the nerve and 
sensibility of diseased teeth. 

Arsenic (Arsenious Acid) * 3 grs. 

Morphine (Sulphate of Morphia) 1 gr. 

They are to be intimately rubbed together, and 
applied directly to the exposed nerve, on a little 
moistened lint or cotton. A little cotton saturated 
with water, rolled into a little pellet the size of a 
wheat-corn, placed upon a pointed instrument, may 



KECIPES. 173 

be made to take up as much of this mixture as will 
adhere to one side of its wet surface, and applied 
to a nerve, without any danger from these two 
powerful drugs. It indeed requires care in using 
them, but with the above directions impressed upon 
the mind, no difficulty need ever be apprehended 
should the pellet be received into the stomach. 

Two or three applications of this preparation 
will, when it can be made immediately to the sen- 
sitive portion of the affected tooth, accomplish all 
that articles of this nature can effect. 

Arsenic in some form is what is commonly made 
use of for this purpose. It produces generally as 
little pain as any thing, and in the combination 
here given is as efficient and as free from danger. 

fteripe— No. 6. 

METALLIC CEMENT, OR AMALGAM. 

Precipitated Silver, or fine Silver filings. 
Crude Mercury, or Quicksilver. 

Take of precipitated silver, or when this can not 
be readily obtained, the filings of silver, as much 
as is supposed sufficient to fill the cavity of the 



174 RECIPES. 

decayed tooth ; place it in the palm of the hand, or, 
what is better, at least more convenient, a small 
glass mortar with pestle, and add a small quantity 
of mercury. Rub them together until they are well 
united. * If the mixture is too soft or liquid, press 
out the surplus mercury with the finger, until what 
remains is sufficiently hard or paste-like and ad- 
hesive to allow of its being held between the thumb 
and finger, and placed in the cavity which it is in- 
tended to stop. A small pair of forceps is best for 
this purpose. When the cavity is filled, the 
amalgam should be pressed down with the finger, 
and made even with its margin. This stopping 
should be used immediately on its preparation, 
and must not' be disturbed for two or three 
hours, as it requires some time to become quite 
hard. 

This preparation is an excellent stopping for the 
temporary teeth of children. If resorted to before 
the teeth become painful, they may generally be 
preserved and rendered useful, until they are 
removed by the natural process, and the pain and 
trouble which usually follow the decay of these 
organs be entirely avoided. 



n e c i r e s , 175 

Itecijie— $0. 7. 

Calcined Alum, pulverized 2 oz. 

Yellow Bark 1 oz. 

Flowers of Sulphur 1 oz. 

To be rubbed together and applied to the parts 
directly in substance. 

The use of this preparation during the admin- 
istration of mercurial remedies will prevent the 
extreme soreness and sponginess of the gums which 
are so common in such cases, and also prevent the 
loosening of the teeth so liable to occur. It will 
also tighten them when made loose from this 
cause. 



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